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Grading of cirrhosis
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Grading of cirrhosis

  I have heard that there is a grading system for cirrhosis.  I believe the ranges went from 1 to 4.  Is there such a system and how is each determined?  Does 1 represent slight damage and 4 macronodular damage?
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Dear Don:
I appreciate your question because it gives me an opportunity to talk about grading systems for liver biopsies.  
I always stress to my readers that when I look at a liver biopsy, I am more concerned about the amount of scarring and I am less concerned about the amount of inflammation.  This is because, it is the scarring that really damages the liver.  We call the scarring, fibrosis in medical terms.  Cirrhosis is an advanced form of fibrosis.
We measure degrees of fibrosis by a variety of measuring systems.  However, one of the simplest and one of my favorites grades fibrosis uses a scale of 1 to 4.  Fibrosis usually begins around a part of the liver called the portal tract.  Using this system, grade 1 does represent mild fibrosis.  Grade 2 represents significant periportal fibrosis (inflammation confined to the area around the portal tracts).  Grade 3 usually refers to fibrosis that extends from one portal tract to another.  The fibrosis bridges one portal tract to another and is called bridging fibrosis.  Grade 4 refers to cirrhosis which is the most advanced form of fibrosis.  
I hope this information is helpful to you but I do feel it is critical that you go over the biopsy results with your physician.  It is easy to misinterpret results and what they mean.  Please let me know if you have any additional questions or information.  You can get back to us through MedHelp or you can contact us directly at (313) 916-8865.   At Henry Ford, we have an active group of liver specialists with a strong experience and interest in hepatitis C.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  





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