COMPUTER MORPHOMETRY FOR QUANTITATIVE MEASUREMENT OF LIVER FIBROSIS -COMPARISON WITH KNODELLS SCORE, COLORIMETRY AND CONVENTIONAL DESCRIPTION REPORTS

Liver fibrosis is currently described quite subjectively or, at best, semiquantitatively by scoring systems. In order to measure the severit y of liver fibrosis quantitatively and to compare this with establishe d methods, such as Knodell's scoring system, the colorimetric method a nd conventional description reports, we undertook the present study. A personal computer with an image grabber card and a microscope equippe d with a computer-controlled slide-driver was used for computer morpho metry. The principle behind morphometry is based on the different colo urs of hepatocytes and fibres following staining with Masson's trichro me stain. There were 31 patients (25 male, six female) recruited into the present study with a mean +/- SD age of 41.6 +/- 15 years (range 2 4-66 years). Of these patients, 16 had chronic hepatitis B, 12 had chr onic hepatitis C and three were alcoholics. Colorimetric methods and K nodell's fibrosis score were performed according to established protoc ols. Conventional description reports were obtained from reviews of pa tient charts. The results from computer morphometry were highly correl ated with results from the colorimetric method, with a correlation coe fficiency gamma = 0.85 (P < 0.0001). The results from computer morphom etry also correlated with both Knodell's scoring system (gamma = 0.69; P < 0.001) and conventional description reports (gamma = 0.46; P < 0. 01). Results from Knodell's scoring system were significantly correlat ed with computer morphometry, as follows: score 0, 2.7 +/- 1.4; score 1, 5.7 +/- 1.2; score 2, 7.7 +/- 2.3; score 3, 10.7 +/- 3.2; score 4, 21.8 +/- 14.1. The trend was statistically significant by the Wilcoxon rank sum test. In conclusion, our computerized morphometry system is a reliable tool for the evaluation of the severity of liver fibrosis a nd can be used as a tool for the objective quantification of liver fib rosis.