Im confused about this

Ive been reading for awhile about bx results and I dont understand.
If you take 10 people with stage 2 liver disease for example--- why would 5 people have bridging and 5 people not have bridging..if they were all a stage 2?
Hope Im getting this across.......
thanks
confused

[tulips27]

I figured it out...thanks! my brain is a little on overload today.
Bye

[ladywhy]

ok. smartypants...'splain to me. :)
I'm now curious, especially since I am stage 2. Hope you are doing ok today...not letting anxiety rule. That is key.

[tulips27]

Stage 2 is the (stage) thats me
Grage 2 is the (grade) thats me
if it were 3 it would be briding?

tell me im right and didnt make a dum dum out of myself!!!
Yeah something wore off and feeling slightly jittery today....only normal its been only 3 days-sice my results are in.

Have I splained to you?? ARGGG.........
Hope your today ok too!!!!!!!!!!!!!!!!
thanks

[ladywhy]

It sounds about right...but i really don't know 4 sure. I do empathize with how you are feeling and it seems like you have an inner strength that will see you through. Allow others to share your fears, and anxiety here. We have all been there. There is a time for laughter and also a time to unburden ourselves and receive support. That's why we are all here. God Bless!
Yvonne

[tulips27]

im trying my best..i do have an inner strength...just hoping it gets me thru and to SVR!  The long  & winding road......

Thanks Yvonne for your support...Hope your tx has been tolerable.
If you can do this I can too!
thanks much
take care & feel well.


From reading about sx I feel like I  have em already!
haaaaaaaaa= not funny but..you know where Im coming from.

Im fine.I need to get back to work tomorrow to occupy the brain!

[ladywhy]

That's the truth...getting out of you own head and focusing on something else like work is a good thing. You're right...i have sometimes wondered during this tx..if some sx i am feeling ARE psychosomatic! You should make the decision to ENJOY this summer and eat really well and take really good care of yourself...pampering and all that...possible vacation??? Because come winter...and time is aflyin'...you may need every ounce of reserve to continue your normal schedule. I believe in prayer....i believe yoga could help you with stress and strength...i have used accupuncture and it has helped me enormously (not while txing...mind you) I can't say enough about that...it was fantastic for stress and much more.  Also, how 'bout..massages. I jumped into tx and then asked questions! Also, check out milk thistle, (before txing), it's known to help the liver, no hocus pocus. Think of this time as "your time" to get yourself  together spiritually, physically and mentally. I wish I had done that. As the cliche states, "hindsite is 20/20. Be good to you, girlfriend!
Y

A dear friend advised me a long time ago, and it has stuck with me (though i certainly have not adhered to it) "Be Gentle with Yourself"...when she said that..I really didn't understand or know how...I am still learning and trying to do just that. Peace.

[ladywhy]

That's just my opinion....

[FullOfHope77]

Ok then, i'm stage 4/4 but grade 2/4 what does that mean? I assume i have cirrohsis but the bridging thing is not clear to me? Can someone explain it? I have a fully functional liver i'm told yet I have state 4/4 Fib/Cir but I guess the saving grace is grade 2/4??? Can someone 'splain that to me :)

[ladywhy]

I wish I could answer your question. We need JmJm or just about anybody but me... I just didn't want you to think I was ignoring you... :) If I were you, I would start another thread in the other forum...that way I know we'll get the answer. I hope you are well and had an enjoyable weekend? I'm gonna drag myself away from here and get some much needed things done...hopefully.
Good night.

[GoofyDad]

Briefly - stage is how much damage has accumulated. Grade is the degree of current inflamation (inflammation). Bridging - going from memeory here - is a defining attribute of stage 3. The fibrotic strands are bridging and connecting to each other. THen comes nodularity.

Stage 4/4 probably means 4 outta 4 - the highest level on that (the Metavir) scale - or cirrhosis. That comes with its own whole set of grading levels.

I'm stage 4 too.

[tulips27]

in another words if your a 2/2 there is no bridging. If your a 2/3 there is bridging? And if your a 3/3 there is bridging. I think I got that part finally...
thanks alot
GoofyDad

[tulips27]

Finally my question was answered in a way in which I understand. Thank you!
I had it in my head pretty much but didnt see anything documented in the way you described.
thanks so much.

[jmjm530]

Tulip: n another words if your a 2/2 there is no bridging. If your a 2/3 there is bridging? And if your a 3/3 there is bridging. I think I got that part finally...
------------------------------
Yes, pretty much, but...

"Forgot the exact terms, but bridging can be complete or partial. In other words, you can have some bridging as a stage 2, but it's not the complete bridging that is characteristic of stage 3. For this reason, some pathologists may make different calls on borderline cases, as some do not believe in staging half-points, such as stage 2.5.  

I had the same set of slides read by 3-4 different pathologists and got stage 3, stage 2 and stage 2.5.   The pathologist who gave me stage "3" thought the bridging was mature, the pathlogist who gave me stage "2" didn't, and the pathologist who gave me stage "2.5" felt I was in the middle but if forced to stage me in whole numbers would have made it stage 2. For this reason, the exact words used in the pathologist's report are often as important (probably more important) as the actual number given and some pathologists (a minority) just use words and not numbers for that reason. All said and done, while pathologist bias (and staging) can account for 1-2 stages, they are not going to confuse a stage 1 with a stage 4, so in most cases you will get a pretty good idea of how much damage you have at least for clinical purposes. If you want more than that, then you probably want to read the words very carefully and have the slides reviewed by at least two pathologists at major liver centers.

-- Jim

[jmjm530]

Here's an analogy, but like most analogies not to be taken literally in its entirety.

You have a drawbridge. When the bridge is open, you have no bridge (bridging). With no bridging you would be stage 0, or 1, or perhaps an early 2.

However, as drawbridge operator starts to close the bridge, the two ends start to come closer together.  At some time the two ends of the bridge meet and that is stage 3.

But what about in between, when the drawbridge isn't open but isn't closed?  Some pathologists might call it stage 2.5 but others are trained to only stage in whole numbers.

Some in this group (the whole number group) might call it stage 2 and some might call it stage 3. Hopefully, the clarification will lie in their description of the half open and half closed bridge. So look at the numbers, read the words, and don't cross the bridge until the red light turns green.

-- Jim

[tulips27]

very interesting..and very true in fact.
Thanks for the explanation in such a manner I can 100% understand.
quite simple
thanks so !

And I'll take your advice..I will wait for the light to turn green!

[susan400]

My last 2 biopsies from 3 years ago and 2 months ago read the same, 2/3 bridging fibrosis.  There was basically no change in the reading over the 3 year period w/2 treatments done in between the 2 biopsies.    I see the fact that it didn't get any worse as a good thing.

Susan

[FullOfHope77]

Good analogy... I'm stage 4/4 so I guess that means I have the big 'C' but grade 2/4 which is where my understanding breaks down. Seems due to 2 varialbles it's not a straighftforward process to understand my condition. If the draw bridge was based on Grade I would feel much better but since the grade is 'only' 2/4 then again I'm not sure how to think about it. Any insights?

[jmjm530]

Stage 4/4 usually means stage 4 out of 4 possible stages, which would be cirrhosis. (Some staging schemes have more than 4 stages). "Grade" is different and doesn't seem as important, or at least my doctors haven't focused on it. Like with "stage", grade 2/4 should mean grade 2 out of 4 possible grades.

-- Jim

[CockSparrow]

The Grade and Stage of a biopsy has the following meanings.

Grade = Inflamation (inflammation) (1-4)
Stage = Scarring (fibrosis) (1-4)
Stage 4 = Cirrhosis and is broken down further.
There are other scoring systems that use a different scale.

Grade is normally reversible
Stage normally isn’t. Although INF can reverse it in some.

CS

[tulips27]

Thanks for the information. Very helpful.