Introduction We have recently shown that CPA assessed in histological section can be used to quantify collagen 1 and has prognostic significance.2 CPA has been evaluated using 4× magnification image capturing, but this conventional CPA technique has limits in sensitivity such that pericellular fibrosis is not captured in these images. A more sensitive image capturing for CPA can validates the conventional CPA.
Methods From a series of 250 trans-jugular liver biopsies in 115 patients transplanted for hepatitis C virus related cirrhosis, 20 slides were randomly selected. After staining with sirius red, they were analysed in random order by 4× (conventional) CPA and 20× (high magnification) CPA by two different authors. The data of previous studies correlating conventional CPA, Ishak score and hepatic venous pressure gradient (HVPG) have been matched with the values of the high magnification CPA. Data have been analysed using linear regression and logistic analysis as appropriate.
Results High magnification CPA and conventional CPA had a good correlation, with a more strict correlation when considering overall fibrosis compared to that performed excluding pericellular fibrosis (R2 0.81 vs 0.79). Results of both CPA techniques are related to the Ishak stages, whereas only high magnification CPA shows significant correlation with the HVPG values in this small series (Abstract 011).
Conclusion A more sensitive image capturing validates the conventional, 4× magnification CPA. Conventional CPA for the easy usability and clinical implications can become part of routine histological liver assessment. Moreover high magnification CPA appears to be an interesting tool to describe liver fibrosis with more details compared to the conventional one.