Aa
Biopsy results
Please does anyone have a link that will explain what these numbers mean.
HAI grade 4 (1+0+1+2) by modified Knodell scoring <<<...I know this has to do with inflamation but what is the (1+0+1+2)?
Portal fibrosis, stage 1/6...this is the stage <<<...is it stage 1 on a scale of 6?
where are the scales for me to look at?
HAI grade 4 (1+0+1+2) by modified Knodell scoring <<<...I know this has to do with inflamation but what is the (1+0+1+2)?
Portal fibrosis, stage 1/6...this is the stage <<<...is it stage 1 on a scale of 6?
where are the scales for me to look at?
Not as familiar with this system, but it appears "Gator" wins the prize.
You appear to be stage 1 out of a possible 6 stages. That would be somewhere between zero and minimal liver damage, or what is termed "mild" on the Janis chart.
The system most of us is METAVIR which only has four stages of fibrosis. Your stage 1 therefore would seem to better than a stage 1 on the Metavir 4-stage system.
So a guarded congratulations on your biopsy if I'm reading it correctly. Please check all this with a liver specialist and/or the pathologist that did the report but it really looks like the best biopsy outcome you could hope for.
Don't know your any of your stats, but in general, having mild liver damage means that one very reasonable option is holding off treatment until better drugs are available.
-- Jim
You appear to be stage 1 out of a possible 6 stages. That would be somewhere between zero and minimal liver damage, or what is termed "mild" on the Janis chart.
The system most of us is METAVIR which only has four stages of fibrosis. Your stage 1 therefore would seem to better than a stage 1 on the Metavir 4-stage system.
So a guarded congratulations on your biopsy if I'm reading it correctly. Please check all this with a liver specialist and/or the pathologist that did the report but it really looks like the best biopsy outcome you could hope for.
Don't know your any of your stats, but in general, having mild liver damage means that one very reasonable option is holding off treatment until better drugs are available.
-- Jim
according to the website you posted - http://janis7hepc.com/biopsies.htm
you are stage 1 of 6 - Portal fibrosis, stage 1/6...
Fibrosis expansion of some portal areas, with or without short fibrous septa (see tbl 5)
and grade 4 of 18 - HAI grade 4 (1+0+1+2) by modified Knodell scoring (see tbl 6)
This (1+0+1+2) means
1 = Mild (focal, few portal areas) - Periportal Necroinflammatory Changes (see tbl 1)
+
0 = Absent - Bridging and Confluent Necrosis (see tbl 2)
+
1 = One focus or less per 10x field - Focal (Spotty) Lobular Necrosis and Heptocellular Apoptosis (see tbl 3)
+
2 = Moderate, some or all portal areas - Portal Inflammation (see tbl 4)
If I am reading the sight accuratley...It looks like you have minimal damage...
you are stage 1 of 6 - Portal fibrosis, stage 1/6...
Fibrosis expansion of some portal areas, with or without short fibrous septa (see tbl 5)
and grade 4 of 18 - HAI grade 4 (1+0+1+2) by modified Knodell scoring (see tbl 6)
This (1+0+1+2) means
1 = Mild (focal, few portal areas) - Periportal Necroinflammatory Changes (see tbl 1)
+
0 = Absent - Bridging and Confluent Necrosis (see tbl 2)
+
1 = One focus or less per 10x field - Focal (Spotty) Lobular Necrosis and Heptocellular Apoptosis (see tbl 3)
+
2 = Moderate, some or all portal areas - Portal Inflammation (see tbl 4)
If I am reading the sight accuratley...It looks like you have minimal damage...
I don't think your biopsy shows cirrhosis. It looks like mild to moderate fibrosis - probably moderate.
Good luck,
Mike
Good luck,
Mike
HISTOLOGY ACTIVITY INDEX (HAI - Knodell Score)
Periportal ± Bridging Necrosis Score Intralobular Degeneration and Focal Necrosis Score Portal Inflammation Score Fibrosis Score
None 0 None 0 No portal inflammation 0 No fibrosis 0
Mild piecemeal necrosis 1 Mild (acidophilic bodies, ballooning degeneration and/or scattered foci of hepatocellular necrosis in 1/3 of lobules or nodules) 1 Mild (sprinkling of inflammatory cells in 1/3 of portal tracts) 1 Fibrous portal expansion 1
Moderate piecemeal necrosis (involves 50% of the circumference of most portal tracts) 3 Moderate (involvement of 1/3-2/3 of lobules or nodules) 3 Moderate (increased inflammatory cells in 1/3-2/3 of portal tracts) 3 Bridging Fibrosis (portal-portal or portal-central linkage) 3
Marked piecemeal necrosis (involves 50% of the circumference of most portal tracts) 4 Marked (involvement of 2/3 of lobules or nodules) 4 Marked (dense packing of inflammatory cells in 2/3 of portal tracts) 4 Cirrhosis 4
Moderate piecemeal necrosis plus bridging necrosis 5 ReferenceKnodell RG, et al.
Marked piecemeal necrosis plus bridging necrosis 6
Multilobular necrosis 10
Periportal ± Bridging Necrosis Score Intralobular Degeneration and Focal Necrosis Score Portal Inflammation Score Fibrosis Score
None 0 None 0 No portal inflammation 0 No fibrosis 0
Mild piecemeal necrosis 1 Mild (acidophilic bodies, ballooning degeneration and/or scattered foci of hepatocellular necrosis in 1/3 of lobules or nodules) 1 Mild (sprinkling of inflammatory cells in 1/3 of portal tracts) 1 Fibrous portal expansion 1
Moderate piecemeal necrosis (involves 50% of the circumference of most portal tracts) 3 Moderate (involvement of 1/3-2/3 of lobules or nodules) 3 Moderate (increased inflammatory cells in 1/3-2/3 of portal tracts) 3 Bridging Fibrosis (portal-portal or portal-central linkage) 3
Marked piecemeal necrosis (involves 50% of the circumference of most portal tracts) 4 Marked (involvement of 2/3 of lobules or nodules) 4 Marked (dense packing of inflammatory cells in 2/3 of portal tracts) 4 Cirrhosis 4
Moderate piecemeal necrosis plus bridging necrosis 5 ReferenceKnodell RG, et al.
Marked piecemeal necrosis plus bridging necrosis 6
Multilobular necrosis 10
Thank you for the info...I think you have it backwards...please correct me if I am wrong
Ok...So now I have some coffee....lets have another look
The report says stage 1/6...that should be stage 1 on a scale of 1 thru 6
This is the inflamation and my score was grade 4 (1+0+1+2)
(A) Periportal or periseptal interface hepatitis (piecemeal necrosis) - associated with hepatocellular necrosis (death of liver cells)
Mild (focal, few portal areas) 1
(B) Confluent necrosis
* Absent 0
(C) Focal (spotty) lytic necrosis, apoptosis and focal inflammation
One focus or less per _10 objective 1
D) Portal inflammation
Moderate, some or all portal areas 2
Ok...So now I have some coffee....lets have another look
The report says stage 1/6...that should be stage 1 on a scale of 1 thru 6
This is the inflamation and my score was grade 4 (1+0+1+2)
(A) Periportal or periseptal interface hepatitis (piecemeal necrosis) - associated with hepatocellular necrosis (death of liver cells)
Mild (focal, few portal areas) 1
(B) Confluent necrosis
* Absent 0
(C) Focal (spotty) lytic necrosis, apoptosis and focal inflammation
One focus or less per _10 objective 1
D) Portal inflammation
Moderate, some or all portal areas 2
You're freakin me out....one of us must have this backwards.,,and I'm new at this so just reconfirm...please....I thought I had minimal damage. I'm seriously confused now.
I thought the grade was inflamation....my report says HAI grade 4 (1+0+1+2) by modified Knodell scoring
the stage is>>>Portal fibrosis, stage 1/6
Tks
Spaz
I thought the grade was inflamation....my report says HAI grade 4 (1+0+1+2) by modified Knodell scoring
the stage is>>>Portal fibrosis, stage 1/6
Tks
Spaz
Here is the info you wanted.
The main thing to know is you have cirrhosis, Stage 4. This has a big impact on your chances for SVR. Although your cirrhosis doesn't appear very advanced. Which is a very very good thing!!! So you may be able to successfully treat with antiviral meds. You should treat as soon as possible before your cirrhosis gets worse. Now is the time you have the greatest chance of SVR.
As far as (1+0+1+2) here is the breakdown on that.
The Ishak Modified HAI
A modification of the Knodell HAI system, more sensitive and accurate in assessing fibrosis. Fibrosis staging is scored from 0 to 6, which permits physicians to better assess the effect of therapy on fibrosis.
HAI: A:1, B:0, C:1, D:2 = 4/18 (4 out of a possible 18)
Ishak modification for hepatic activity index (HAI) for scoring of necroinflammatory activity in chronic hepatitis
(A) Periportal or periseptal interface hepatitis (piecemeal necrosis) - associated with hepatocellular necrosis (death of liver cells)
Absent 0
Mild (focal, few portal areas) 1
* Mild/moderate (focal, most portal areas) 2
Moderate (continuous around o50% of tracts or septa) 3
Severe (continuous around 450% of tracts or septa) 4
(B) Confluent necrosis
* Absent 0
Focal confluent necrosis 1
Zone 3 necrosis in some areas 2
Zone 3 necrosis in most areas 3
Zone 3 necrosis+occasional portal-central (P-C) bridging 4
Zone 3 necrosis+multiple P-C bridging 5
Panacinar or multiacinar necrosis 6
(C) Focal (spotty) lytic necrosis, apoptosis and focal inflammation
Absent 0
One focus or less per _10 objective 1
* Two to four foci per _10 objective 2
Five to ten foci per _10 objective 3
More than ten foci per _10 objective 4
(D) Portal inflammation
Absent 0
Mild, some or all portal areas 1
Moderate, some or all portal areas 2
* Moderate/marked, all portal areas 3
Marked, all portal areas 4
Best of luck!
Cheers!
Hector
The main thing to know is you have cirrhosis, Stage 4. This has a big impact on your chances for SVR. Although your cirrhosis doesn't appear very advanced. Which is a very very good thing!!! So you may be able to successfully treat with antiviral meds. You should treat as soon as possible before your cirrhosis gets worse. Now is the time you have the greatest chance of SVR.
As far as (1+0+1+2) here is the breakdown on that.
The Ishak Modified HAI
A modification of the Knodell HAI system, more sensitive and accurate in assessing fibrosis. Fibrosis staging is scored from 0 to 6, which permits physicians to better assess the effect of therapy on fibrosis.
HAI: A:1, B:0, C:1, D:2 = 4/18 (4 out of a possible 18)
Ishak modification for hepatic activity index (HAI) for scoring of necroinflammatory activity in chronic hepatitis
(A) Periportal or periseptal interface hepatitis (piecemeal necrosis) - associated with hepatocellular necrosis (death of liver cells)
Absent 0
Mild (focal, few portal areas) 1
* Mild/moderate (focal, most portal areas) 2
Moderate (continuous around o50% of tracts or septa) 3
Severe (continuous around 450% of tracts or septa) 4
(B) Confluent necrosis
* Absent 0
Focal confluent necrosis 1
Zone 3 necrosis in some areas 2
Zone 3 necrosis in most areas 3
Zone 3 necrosis+occasional portal-central (P-C) bridging 4
Zone 3 necrosis+multiple P-C bridging 5
Panacinar or multiacinar necrosis 6
(C) Focal (spotty) lytic necrosis, apoptosis and focal inflammation
Absent 0
One focus or less per _10 objective 1
* Two to four foci per _10 objective 2
Five to ten foci per _10 objective 3
More than ten foci per _10 objective 4
(D) Portal inflammation
Absent 0
Mild, some or all portal areas 1
Moderate, some or all portal areas 2
* Moderate/marked, all portal areas 3
Marked, all portal areas 4
Best of luck!
Cheers!
Hector
I found this but I don't understand how my results relate to it.
http://janis7hepc.com/biopsies.htm
http://janis7hepc.com/biopsies.htm
Give it some time. The right people just haven't seen it. Do you know how to change passwords?
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