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

World Journal of Gastroenterology 2009年第42期15卷 5326-5333页

作者： Way Seah Lee lai meng looi Department of Paediatrics University of Malaya Medical CentreKuala Lumpur 59100Malaysia Department of Pathology University of Malaya Medical CentreKuala Lumpur 59100Malaysia

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.

关键词： Histology scoring system Liver biopsy Neonatal cholestasis

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