A comparative analysis of six current histological classification schemes and scoring systems used in chronic hepatitis reporting

Abstract

SUMMARY The purpose of the present paper is to ascertain if and how the Old Qualitative Classification correlates with the newer semi-quantitative scoring systems, including the Knodell Histological Activity Index (HAI), Ishak Modified HAI, Scheuer, Batts-Ludwig, and the METAVIR scoring systems, and how these scoring systems correlate with each other. The study was carried out with liver biopsies from fifty consecutive cases of chronic hepatitis. Each case was classified and scored using all 6 systems and correlation studies were subsequently carried out. The semi-quantitative scoring systems showed good statistical correlation among themselves. It is therefore possible to compare chronic hepatitis biopsies from different centres where any of these 5 semi-quantitative scoring systems are used. Also the results of therapeutic trials using any of these scoring systems can be compared. The Old Qualitative Classification only showed significant association with the necroinflammatory activity score of the Knodell scheme but not with its fibrosis score.