Collagen Immunohistochemical Stains in the Liver Are Useful in Differentiating Capsular from Septal Fibrosis
Jonathan B Rock, Martha M Yearsley, Adam J Hanje, Wendy L Frankel. The Ohio State University Medical Center, Columbus, OH
Background: Cirrhosis is a significant cause of morbidity and mortality with increasing incidence worldwide. While progress has been made in clinical and radiographic diagnosis of cirrhosis, core needle biopsy (CBx) remains essential. It is not unusual to receive severely fragmented CBx, particularly when significant fibrosis is present. The distinction between capsular/subcapsular (Cap) fibrosis and true septal (Sep) fibrosis can be challenging in fragmented CBx, leading to potential over-staging of fibrosis. Collagens and glycoproteins are natural components of hepatic parenchyma, which accumulate in varying proportions as hepatic fibrosis progresses. We evaluated the utility of staining for collagen types and common glycoproteins in differentiating Cap from Sep fibrosis.
Design: Consecutive explanted cirrhotic livers (15) were identified and whole-sections containing adequate Cap and Sep fibrosis were stained for Vitronectin, Orcein, Laminin, Trichrome and Collagens III, IV, V and VI. Staining was graded as negative (0), weak (1) or strong (2). Statistical analysis was performed using a paired T-test. To attempt to mimic the clinical problem of CBx with fragmentation, CBx were obtained from 5 additional explanted cirrhotic livers with inked capsules using an 18-gauge biopsy needle. These were evaluated as previously described.
|Collagen III||Collagen IV||Collagen V||Collagen VI||Vitronectin||Orcein|