Long-term evolution of fibrosis from chronic hepatitis to
cirrhosis in patients with hepatitis C: morphometric analysis
of repeated biopsies.
Kage M, Shimamatu K, Nakashima E, Kojiro M, Inoue O, Yano M
First Department of Pathology, Kurume University School of
Medicine, Fukuoka, Japan.
To clarify the characteristics of fibrosis developed in the
process from chronic hepatitis C to cirrhosis, a morphometric
analysis of liver biopsy samples was conducted on 25 chronic
hepatitis C patients and 20 chronic hepatitis B patients
(controls). Hepatitis C patients were followed up for 3 to 23
years. The mean number of liver biopsies performed on these
patients was 3.8. Each biopsy was evaluated for the degree of
fibrosis by using two methods: a semiquantitative method with
scoring system, and morphometry using a computed image
analysis system. A significant correlation was observed
between the Stage and the area of fibrosis (AF = the ratio of
the area of fibrosis to that of the entire tissue specimen).
The AF in cirrhosis was significantly higher in hepatitis C
patients than in hepatitis B patients. The ratio of AF in the
last biopsy sample to AF in the initial biopsy sample was
significantly higher in hepatitis C patients than in hepatitis
B patients. Evolution from chronic hepatitis C to cirrhosis
occurred more frequently in patients aged > or = 50 years,
and this time period was 1.8 times shorter than that in
patients aged less than 50 years. AF in the initial biopsy
related significantly to the period of evolution from chronic
hepatitis C to cirrhosis. AF in the initial biopsy might be a
predictive factor for prognosis.
PMID: 9096615, MUID: 97250932