Systematic quantification of histological patterns shows accuracy in reflecting cirrhotic remodeling

作者：Wang, Yan^*; Huang, Wei; Li, Ruhua; Yun, Zhaoqiang; Zhu, Youfu; Yang, Jinlian; Liu, Hailin; Liu, Zhipeng; Feng, Qianjin^*; Hou, Jinlin

来源：Journal of Gastroenterology and Hepatology, 2017, 32(9): 1631-1639.

DOI：10.1111/jgh.13722

• animal model
• biopsy
• chronic hepatitis B
• fibrosis change
• liver cirrhosis
• liver fibrosis
• quantitative image analysis

Background and Aim: There still lacks a tool for precisely evaluating cirrhotic remodeling. Histologic distortion characterized in cirrhosis (i.e. cirrhotic patterns) has a validated pathophysiological meaning and potential relevance to clinical complications. We aimed to establish a new tool to quantify the cirrhotic patterns and test it for reflecting the cirrhotic remodeling. @@@ Methods: We designed a computerized algorithm, named qCP, dedicated for the analysis of liver images acquired by second harmonic microscopy. We evaluated its measurement by using a cohort of 95 biopsies (Ishak staging F4/5/6 = 33/35/27) of chronic hepatitis B and a carbon tetrachloride-intoxicated rat model for simulating the bidirectional cirrhotic change. @@@ Results: QCP can characterize 14 histological cirrhosis parameters involving the nodules, septa, sinusoid, and vessels. For chronic hepatitis B biopsies, the mean overall intraobserver and inter-observer agreement was 0.94 +/- 0.08 and 0.93 +/- 0.09, respectively. The robustness in resisting sample adequacy-related scoring error was demonstrated. The proportionate areas of total (collagen proportionate area), septal (septal collagen proportionate area [ SPA]), sinusoidal, and vessel collagen, nodule area, and nodule density (ND) were associated with Ishak staging (P < 0.01 for all). But only ND and SPA were independently associated (P <= 0.001 for both). A histological cirrhosis parameterscomposed qCP-index demonstrated an excellent accuracy in quantitatively diagnosing evolving cirrhosis (areas under receiver operating characteristic curves 0.95-0.92; sensitivity 0.93-0.82; specificity 0.94-0.85). In the rat model, changes in collagen proportionate area, SPA, and ND had strong correlations with both cirrhosis progression and regression and faithfully characterized the histological evolution. @@@ Conclusions: QCP preliminarily demonstrates potential for quantitating cirrhotic remodeling with high resolution and accuracy. Further validation with in-study cohorts and multiple-etiologies is warranted.

• 出版日期2017-9
• 单位南方医科大学