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Beyond scoring: a modern histological assessment of chronic hepatitis should include tissue angiogenesis
  1. Maria Guido1,
  2. Marco Pizzi1,
  3. David Sacerdoti2,
  4. Luciano Giacomelli1,
  5. Massimo Rugge1,
  6. Massimo Bolognesi2
  1. 1Surgical Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
  2. 2Department of Medicine-DIMED, Clinica Medica V, University of Padova, Padova, Italy
  1. Correspondence to Dr Maria Guido, Surgical Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Via Gabelli, 61, Padova 35121, Italy; mguido{at}

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We read with great interest the leading article by Rosselli et al1 which offers a contemporary perspective to the clinical issue of interpreting progression (and regression) of chronic liver diseases (CLDs).

We fully agree with the view that the histological scoring of fibrosis is a reductive approach to the assessment of CLDs, as it does not fully reflect the complex events involved in the progression to cirrhosis. As suggested by Rosselli et al, a more insightful morphological analysis of liver biopsy should consider other important factors contributing to disease progression/regression, and possibly to cancer development. Angiogenesis represents one of such key factors.

Liver angiogenesis is a pathophysiological process characterised by changes in the phenotype of sinusoidal endothelial cells, which assume the features of capillary endothelial cells. This process, …

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  • Contributors Conception and design: MG, MB. Histological analysis: MG, MP. Acquisition of data: MG, MP, DS, MR, MB. Statistical analysis: LG. Drafting the manuscript: MG and MP. All authors contributed to the critical revision of the manuscript.

  • Competing interests None.

  • Ethics approval Ethics Committee.

  • Provenance and peer review Not commissioned; internally peer reviewed.