Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension

Moon Young Kim, Mee Yon Cho, Soon Koo Baik, Hong Jun Park, Hyo Keun Jeon, Chong Kun Im, Chan Sik Won, Jae Woo Kim, Hyun Soo Kim, Sang Ok Kwon, Min Seob Eom, Seung Hwan Cha, Young Ju Kim, Sei Jin Chang, Samuel S. Lee

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Background & Aims: Further histological subclassification of cirrhosis may be useful because of heterogeneity of severity within cirrhosis. We aimed to determine the relationship between histological subclassification and clinical stage of cirrhosis as well as grade of portal hypertension. Methods: One hundred-twenty-three biopsy-proven cirrhosis patients, whose clinical stage of cirrhosis and hepatic venous pressure gradient (HVPG) could be estimated, were included in this prospective study. Histology of cirrhosis was blindly subclassified using the Laennec fibrosis scoring system semi-quantitatively without knowledge of the clinical stage or the HVPG results. The Laennec system subclassifies cirrhosis as mild - thin septa, moderate - at least two broad septa, and severe - at least one very broad septum or many minute nodules. Clinical stages were determined by the presence or absence of varices, ascites, and variceal hemorrhage. Biological and laboratory data were also collected. Results: Alcohol intake was the most common cause of cirrhosis in this cohort (87, 70.7%). Histology of cirrhosis subclassified using the Laennec scoring system significantly correlated with both the clinical stage of cirrhosis (p <0.001) and HVPG (mild: 8.1 ± 2.6 mm Hg, moderate: 12.4 ± 3.3 mm Hg, severe: 16.3 ± 4.0 mm Hg, p <0.001). With higher grades of histological subclassification of cirrhosis, increased frequency in both severe portal hypertension (HVPG ≥12 mm Hg) and episodes of variceal hemorrhage were observed (p <0.001). Conclusions: Histological subclassification of cirrhosis by the Laennec fibrosis scoring system is tightly correlated with both the clinical stage of cirrhosis and grade of portal hypertension. This suggests that cirrhosis should be subclassified into different stages according to its histological severity.

Original languageEnglish
Pages (from-to)1004-1009
Number of pages6
JournalJournal of Hepatology
Volume55
Issue number5
DOIs
Publication statusPublished - 2011 Nov 1

Fingerprint

Portal Hypertension
Fibrosis
Venous Pressure
Liver
Histology
Hemorrhage
Varicose Veins
Ascites
Liver Cirrhosis

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Kim, Moon Young ; Cho, Mee Yon ; Baik, Soon Koo ; Park, Hong Jun ; Jeon, Hyo Keun ; Im, Chong Kun ; Won, Chan Sik ; Kim, Jae Woo ; Kim, Hyun Soo ; Kwon, Sang Ok ; Eom, Min Seob ; Cha, Seung Hwan ; Kim, Young Ju ; Chang, Sei Jin ; Lee, Samuel S. / Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension. In: Journal of Hepatology. 2011 ; Vol. 55, No. 5. pp. 1004-1009.
@article{e6fd46aaffdf4c62965022018d35d5d0,
title = "Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension",
abstract = "Background & Aims: Further histological subclassification of cirrhosis may be useful because of heterogeneity of severity within cirrhosis. We aimed to determine the relationship between histological subclassification and clinical stage of cirrhosis as well as grade of portal hypertension. Methods: One hundred-twenty-three biopsy-proven cirrhosis patients, whose clinical stage of cirrhosis and hepatic venous pressure gradient (HVPG) could be estimated, were included in this prospective study. Histology of cirrhosis was blindly subclassified using the Laennec fibrosis scoring system semi-quantitatively without knowledge of the clinical stage or the HVPG results. The Laennec system subclassifies cirrhosis as mild - thin septa, moderate - at least two broad septa, and severe - at least one very broad septum or many minute nodules. Clinical stages were determined by the presence or absence of varices, ascites, and variceal hemorrhage. Biological and laboratory data were also collected. Results: Alcohol intake was the most common cause of cirrhosis in this cohort (87, 70.7{\%}). Histology of cirrhosis subclassified using the Laennec scoring system significantly correlated with both the clinical stage of cirrhosis (p <0.001) and HVPG (mild: 8.1 ± 2.6 mm Hg, moderate: 12.4 ± 3.3 mm Hg, severe: 16.3 ± 4.0 mm Hg, p <0.001). With higher grades of histological subclassification of cirrhosis, increased frequency in both severe portal hypertension (HVPG ≥12 mm Hg) and episodes of variceal hemorrhage were observed (p <0.001). Conclusions: Histological subclassification of cirrhosis by the Laennec fibrosis scoring system is tightly correlated with both the clinical stage of cirrhosis and grade of portal hypertension. This suggests that cirrhosis should be subclassified into different stages according to its histological severity.",
author = "Kim, {Moon Young} and Cho, {Mee Yon} and Baik, {Soon Koo} and Park, {Hong Jun} and Jeon, {Hyo Keun} and Im, {Chong Kun} and Won, {Chan Sik} and Kim, {Jae Woo} and Kim, {Hyun Soo} and Kwon, {Sang Ok} and Eom, {Min Seob} and Cha, {Seung Hwan} and Kim, {Young Ju} and Chang, {Sei Jin} and Lee, {Samuel S.}",
year = "2011",
month = "11",
day = "1",
doi = "10.1016/j.jhep.2011.02.012",
language = "English",
volume = "55",
pages = "1004--1009",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier",
number = "5",

}

Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension. / Kim, Moon Young; Cho, Mee Yon; Baik, Soon Koo; Park, Hong Jun; Jeon, Hyo Keun; Im, Chong Kun; Won, Chan Sik; Kim, Jae Woo; Kim, Hyun Soo; Kwon, Sang Ok; Eom, Min Seob; Cha, Seung Hwan; Kim, Young Ju; Chang, Sei Jin; Lee, Samuel S.

In: Journal of Hepatology, Vol. 55, No. 5, 01.11.2011, p. 1004-1009.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension

AU - Kim, Moon Young

AU - Cho, Mee Yon

AU - Baik, Soon Koo

AU - Park, Hong Jun

AU - Jeon, Hyo Keun

AU - Im, Chong Kun

AU - Won, Chan Sik

AU - Kim, Jae Woo

AU - Kim, Hyun Soo

AU - Kwon, Sang Ok

AU - Eom, Min Seob

AU - Cha, Seung Hwan

AU - Kim, Young Ju

AU - Chang, Sei Jin

AU - Lee, Samuel S.

PY - 2011/11/1

Y1 - 2011/11/1

N2 - Background & Aims: Further histological subclassification of cirrhosis may be useful because of heterogeneity of severity within cirrhosis. We aimed to determine the relationship between histological subclassification and clinical stage of cirrhosis as well as grade of portal hypertension. Methods: One hundred-twenty-three biopsy-proven cirrhosis patients, whose clinical stage of cirrhosis and hepatic venous pressure gradient (HVPG) could be estimated, were included in this prospective study. Histology of cirrhosis was blindly subclassified using the Laennec fibrosis scoring system semi-quantitatively without knowledge of the clinical stage or the HVPG results. The Laennec system subclassifies cirrhosis as mild - thin septa, moderate - at least two broad septa, and severe - at least one very broad septum or many minute nodules. Clinical stages were determined by the presence or absence of varices, ascites, and variceal hemorrhage. Biological and laboratory data were also collected. Results: Alcohol intake was the most common cause of cirrhosis in this cohort (87, 70.7%). Histology of cirrhosis subclassified using the Laennec scoring system significantly correlated with both the clinical stage of cirrhosis (p <0.001) and HVPG (mild: 8.1 ± 2.6 mm Hg, moderate: 12.4 ± 3.3 mm Hg, severe: 16.3 ± 4.0 mm Hg, p <0.001). With higher grades of histological subclassification of cirrhosis, increased frequency in both severe portal hypertension (HVPG ≥12 mm Hg) and episodes of variceal hemorrhage were observed (p <0.001). Conclusions: Histological subclassification of cirrhosis by the Laennec fibrosis scoring system is tightly correlated with both the clinical stage of cirrhosis and grade of portal hypertension. This suggests that cirrhosis should be subclassified into different stages according to its histological severity.

AB - Background & Aims: Further histological subclassification of cirrhosis may be useful because of heterogeneity of severity within cirrhosis. We aimed to determine the relationship between histological subclassification and clinical stage of cirrhosis as well as grade of portal hypertension. Methods: One hundred-twenty-three biopsy-proven cirrhosis patients, whose clinical stage of cirrhosis and hepatic venous pressure gradient (HVPG) could be estimated, were included in this prospective study. Histology of cirrhosis was blindly subclassified using the Laennec fibrosis scoring system semi-quantitatively without knowledge of the clinical stage or the HVPG results. The Laennec system subclassifies cirrhosis as mild - thin septa, moderate - at least two broad septa, and severe - at least one very broad septum or many minute nodules. Clinical stages were determined by the presence or absence of varices, ascites, and variceal hemorrhage. Biological and laboratory data were also collected. Results: Alcohol intake was the most common cause of cirrhosis in this cohort (87, 70.7%). Histology of cirrhosis subclassified using the Laennec scoring system significantly correlated with both the clinical stage of cirrhosis (p <0.001) and HVPG (mild: 8.1 ± 2.6 mm Hg, moderate: 12.4 ± 3.3 mm Hg, severe: 16.3 ± 4.0 mm Hg, p <0.001). With higher grades of histological subclassification of cirrhosis, increased frequency in both severe portal hypertension (HVPG ≥12 mm Hg) and episodes of variceal hemorrhage were observed (p <0.001). Conclusions: Histological subclassification of cirrhosis by the Laennec fibrosis scoring system is tightly correlated with both the clinical stage of cirrhosis and grade of portal hypertension. This suggests that cirrhosis should be subclassified into different stages according to its histological severity.

UR - http://www.scopus.com/inward/record.url?scp=80054749411&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054749411&partnerID=8YFLogxK

U2 - 10.1016/j.jhep.2011.02.012

DO - 10.1016/j.jhep.2011.02.012

M3 - Article

C2 - 21354227

AN - SCOPUS:80054749411

VL - 55

SP - 1004

EP - 1009

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

IS - 5

ER -