Sampling Error in Histopathology Findings of Nonalcoholic Fatty Liver Disease: A Post Mortem Liver Histology Study.

Background: Many clinical trials and natural history studies on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) rely heavily on liver histology to define their endpoints. There are many indications that the liver is not uniformly involved in NAFLI thus sampling error...

Descripción completa

Detalles Bibliográficos
Publicado en:Archives of Iranian Medicine (AIM) Vol. 15; no. 7; pp. 418 - 422
Autores principales: Merat, Shahin, Sotoudehmanesh, Rasoul, Nouraie, Mehdi, Peikan-Heirati, Masoumeh, Sepanlou, Sadaf G., Malekzadeh, Reza, Sotoudeh, Masoud
Formato: research tables/charts Journal Article
Publicado: Academy of Medical Sciences of I.R. Iran Jul2012
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=78358475&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 78358475
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        10292977
        5DHN
      jtl: Archives of Iranian Medicine (AIM)
      issn: 10292977
      maglogo: N
    pubinfo:
      dt: Jul2012
      vid: 15
      iid: 7
      pid: 42042
      pub: Academy of Medical Sciences of I.R. Iran
      place: , <Blank>
    artinfo:
      ui:
        78358475
        78358475
        108141129
        78358475
      ppf: 418
      ppct: 4
      formats:
      tig:
        atl: Sampling Error in Histopathology Findings of Nonalcoholic Fatty Liver Disease: A Post Mortem Liver Histology Study.
      aug:
        au:
          Merat, Shahin
          Sotoudehmanesh, Rasoul
          Nouraie, Mehdi
          Peikan-Heirati, Masoumeh
          Sepanlou, Sadaf G.
          Malekzadeh, Reza
          Sotoudeh, Masoud
        affil: Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
      sug:
        subj:
          Fatty Liver Physiopathology
          Histology Methods
          Human
          Data Analysis Software
          Postmortem Care
          Male
          Autopsy
          Female
          Child
          Adolescence
          Adult
          Middle Age
          Aged, 80 and Over
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Male
          Female
      ab: Background: Many clinical trials and natural history studies on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) rely heavily on liver histology to define their endpoints. There are many indications that the liver is not uniformly involved in NAFLI thus sampling error is a major concern. This study aims to evaluate the uniformity of various histologic features in livers affected with NAFLC Methods: Samples from a forensic autopsy series were studied and subjects with NAFLD identified. We took specimens from three different parts of each liver and recorded the degrees of steatosis, hepatocyte ballooning, lobular inflammation, portal inflammation, and fibrosis. NASH activity index (NAI) which is the sum of scores of histologic features was also calculated. The agreement between the 3 samples from each liver was studied. Results: There were 945 autopsies performed; 896 were suitable for histologic evaluation and 283 had NAFLD. Of these, 146 livers were available to our study from which 438 samples were taken. Fibrosis[intra-class correlation (ICC) = 0.87], lobular inflammation (kappa = 0.83 and portal inflammation (kappa = 0.83)were fairly uniformly distributed in the damaged liver. Steatosis was less uniform (kappa = 0.64), and hepatocyte ballooning was least uniformly distributed (kappa = 0.57). The ICC for NAI was 0.86, which indicated good agreement. Conclusions: The individual histologic features of NAFLD and NASH are not uniformly distributed in the liver. Hepatocyte ballooning is especially non-uniform. Such non-uniformity should be taken into account when interpreting results of studies that rely on paired biopsies. A summary score such as NAI is less affected by sampling error.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N