The nonalcoholic steatohepatitis extended hepatocyte ballooning score: histologic classification and clinical significance

Ryan M Gill; Daniela Allende; Patricia H Belt; Cynthia A Behling; Oscar W Cummings; Cynthia D Guy; Daniela Carpenter; Brent A Neuschwander-Tetri; Arun J Sanyal; James Tonascia; Mark L Van Natta; Laura A Wilson; Goro Yamada; Matthew Yeh; David E Kleiner; Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)

doi:10.1097/HC9.0000000000000033

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The nonalcoholic steatohepatitis extended hepatocyte ballooning score: histologic classification and clinical significance

Journal article

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The nonalcoholic steatohepatitis extended hepatocyte ballooning score: histologic classification and clinical significance

Ryan M Gill, Daniela Allende, Patricia H Belt, Cynthia A Behling, Oscar W Cummings, Cynthia D Guy, Daniela Carpenter, Brent A Neuschwander-Tetri, Arun J Sanyal, James Tonascia, …

Hepatology communications, v 7(2), 0033

01 Feb 2023

DOI: https://doi.org/10.1097/HC9.0000000000000033

PMID: 36724127

Featured in Collection : UN Sustainable Development Goals @ Drexel

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Abstract

Clinical Relevance

Female

Hepatocytes - pathology

Humans

Liver Cirrhosis - diagnosis

Liver Cirrhosis - pathology

Male

Non-alcoholic Fatty Liver Disease - diagnosis

Non-alcoholic Fatty Liver Disease - pathology

Metabolic Syndrome

The NAFLD activity score was developed to measure histologic changes in NAFLD during therapeutic trials. Hepatocyte ballooning (HB) is the most specific feature in steatohepatitis diagnosis, yet the impact of variations in HB has not been incorporated. Liver biopsies from patients enrolled in the NASH Clinical Research Network with an initial diagnosis of NASH or NAFL (n=1688) were evaluated to distinguish classic hepatocyte ballooning (cHB) from smaller, nonclassic hepatocyte ballooning (nHB), and also to designate severe ballooning and assign an extended hepatocyte ballooning (eB) score [0 points, no ballooning (NB); 1 point, few or many nHB; 2 points, few cHB; 3 points, many cHB; 4 points, severe cHB] to the biopsy assessment. The eB score was reproducible among NASH CRN liver pathologists (weighted kappa 0.76) and was significantly associated with older age (mean 52.1 y, cHB; 48.5 y, nHB, p<0.001), gender (72.3% female, cHB; 54.5% female, nHB, p<0.001), diabetes (49.8% diabetes, cHB; 28.2% diabetes, nHB, p<0.001), metabolic syndrome (68.5% metabolic syndrome, nHB; 50.2% metabolic syndrome, NB, p<0.001), and body mass index [33.2, 34.2, 35 mean body mass index (kg/m2); NB, nHB, and cHB, respectively, p<0.05]. Finally, fibrosis stage, as a marker of disease severity, was significantly correlated with the eB score (p<0.001). The eB score allows for a reproducible and more precise delineation of the range of ballooned hepatocyte morphology and corresponds with both clinical features of NASH and fibrosis stage.

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17 citations in Web of Science

16 citations in Scopus

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Title: The nonalcoholic steatohepatitis extended hepatocyte ballooning score: histologic classification and clinical significance
Creators: Ryan M Gill - University of California, San Francisco
Daniela Allende - Cleveland Clinic
Patricia H Belt - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Cynthia A Behling - Sharp Memorial Hospital
Oscar W Cummings - Indiana University Indianapolis
Cynthia D Guy - Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
Daniela Carpenter - Department of Pathology, Saint Louis University, St. Louis, Missouri, USA
Brent A Neuschwander-Tetri - Saint Louis University
Arun J Sanyal - Virginia Commonwealth University
James Tonascia - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Mark L Van Natta - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Laura A Wilson - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Goro Yamada - Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Matthew Yeh - University of Washington
David E Kleiner - Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)
Publication Details: Hepatology communications, v 7(2), 0033
Publisher: Lippincott
Grant note: U01 DK061737 / NIDDK NIH HHS U01 DK061713 / NIDDK NIH HHS UL1 TR000006 / NCATS NIH HHS U01 DK061718 / NIDDK NIH HHS U01 DK061728 / NIDDK NIH HHS U01 DK061732 / NIDDK NIH HHS UL1 TR000448 / NCATS NIH HHS U24 DK061730 / NIDDK NIH HHS UL1 TR000436 / NCATS NIH HHS UL1 TR000100 / NCATS NIH HHS UL1 TR000004 / NCATS NIH HHS UL1 TR000439 / NCATS NIH HHS U01 DK061730 / NIDDK NIH HHS U01 DK061738 / NIDDK NIH HHS U01 DK061734 / NIDDK NIH HHS UL1 TR000058 / NCATS NIH HHS UL1 TR000423 / NCATS NIH HHS U01 DK061731 / NIDDK NIH HHS
Resource Type: Journal article
Language: English
Academic Unit: Epidemiology and Biostatistics
Web of Science ID: WOS:001058457700018
Scopus ID: 2-s2.0-85181182043
Other Identifier: 991021875345604721

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Collaboration types: Domestic collaboration
Web of Science research areas: Gastroenterology & Hepatology

The nonalcoholic steatohepatitis extended hepatocyte ballooning score: histologic classification and clinical significance

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UN Sustainable Development Goals (SDGs)

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