Usefulness of a scoring system in the interpretation of histology in neonatal cholestasis

作     者：Way Seah Lee Lai Meng Looi 

作者机构：Department of PaediatricsUniversity of Malaya Medical CentreKuala Lumpur 59100Malaysia Department of PathologyUniversity of Malaya Medical CentreKuala Lumpur 59100Malaysia 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2009年第15卷第42期

页      面：5326-5333页

核心收录：

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：Supported by A research grant from Vote F University of Malaya Kuala Lumpur Malaysia 

主　　题：Histology scoring system Liver biopsy Neonatal cholestasis 

摘      要：AIM:To ascertain the usefulness of a histological scoring system devised to assist in the interpretation of liver histology in neonatal cholestasis(NC) .METHODS:Liver biopsy specimens obtained from infants with NC referred to a tertiary pediatric unit in Malaysia were prospectively *** first author,blinded to the final diagnosis,devised the histological diagnosis based on a 7-feature(portal ductal proliferation,bile plugs in portal ductules,portoportal bridging,lymphocytic infiltration in portal region,multinucleated hepatocytes,neutrophilic infiltration,hepatocellular swelling) ,15-point(0 to 15) scoring *** author classified the histological diagnosis as either biliary atresia(BA) or neonatal hepatitis(NH,all other diagnoses) ,and subsequently compared the author s diagnosis with the final ***:Eighty-four biopsy specimens obtained from 78 patients were *** the scoring system,BA was correctly diagnosed by the author histologically in 30 cases,labelled as NH in *** other diagnoses,BA was excluded correctly in 33 cases and mislabeled as BA in 2 *** overall sensitivity for BA was 91%,specificity 86% and accuracy 88%.With the scoring system,a score of ≥ 7 had the best diagnostic utility to differentiate BA from other intrahepatic cholestasis histologically(sensitivity 88%,specificity 94%,accuracy 92%) .Four patients with a score 7 had BA,and 3 patients with a score ≥ 7 had ***:A 7-feature,15-point histological scoring system had good diagnostic accuracy in the interpretation of liver histology in neonatal cholestasis.