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Analytical Cellular Pathology
Volume 2014, Article ID 526979, 6 pages
http://dx.doi.org/10.1155/2014/526979
Research Article

Nonalcoholic Fatty Liver Disease: Different Classifications Concordance and Relationship between Degrees of Morphological Features and Spectrum of the Disease

1Postgraduate Program, Department of Pathology, University Hospital, Faculty of Medicine, Federal University of Rio de Janeiro, Avenida Prof. Rodolpho Paulo Rocco 255, Cidade Universitária, 21941-913 Rio de Janeiro, RJ, Brazil
2Faculty of Medicine, Severino Sombra University, Avenida Expedicionário Oswaldo de Almeida Ramos 280, Centro, 27700-000 Vassouras, RJ, Brazil
3Department of Pathology, University Hospital, Faculty of Medicine, Federal University of Rio de Janeiro, Avenida Prof. Rodolpho Paulo Rocco 255, Cidade Universitária, 21941-913 Rio de Janeiro, RJ, Brazil

Received 31 July 2014; Accepted 16 October 2014

Copyright © 2014 Juliana Maya Monteiro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The morphological features of nonalcoholic fatty liver disease (NAFLD) range from steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. Liver biopsy remains the main tool for NASH diagnosis and many histological systems to diagnose and grade NAFLD were proposed. We evaluated the relationship among NAFLD activity score (NAS), histological diagnoses (non-NASH, possible NASH, and definite NASH), and histological algorithm proposed by Bedossa et al.; additionally the degrees of morphological features were semiquantified and correlated with non-NASH and NASH. Seventy-one liver biopsies were studied. The agreement among the three systems considering NASH and non-NASH was excellent (). Among the 22 biopsies with NAS 3-4, 72.7% showed to be NASH according to Bedossa’s algorithm. The degree of steatosis, ballooning, lobular inflammation, and fibrosis stage were correlated with NASH (). Fibrosis stage 1 was also found in non-NASH. Over the spectrum of NAFLD, no association was observed between intensity of steatosis and fibrosis grade. The degrees of lobular inflammation showed association with fibrosis stage (). In conclusion, there is agreement among different NAFLD classifications and NAS > 4 may be a better cutoff from which to consider NASH diagnosis; besides the highest degrees of steatosis, ballooning, inflammation, and fibrosis are associated with NASH.