The aim of this paper is to provide guidelines for
the pathologist on the definition, nomenclature, and
classification of hepatic cirrhosis and related conditions.
Many systems of classification are in current
use in different parts of the world (Table 1). This
hinders comparisons of published data and the
accurate evaluation of relationships between cirrhosis
and liver cancer. Different words have been used
to describe essentially similar features; thus ' septal ',
'regular ', ' uniform ', ' micronodular ', and ' monolobular'
all refer to a particular morphological
pattern of cirrhosis which is widely recognized.
Conversely, a single word may be applied to a variety
of forms; for example, 'portal ' cirrhosis means one
with regular, small nodules to some, but is used by
others for any cirrhotic liver without further qualification.
Another weakness of some classifications is
that they are based on a mixture of pathogenesis,
morphology, and etiology (e.g. 'post-necrotic ',
' portal ', and ' biliary ' cirrhosis). There is, therefore,
a need for a logical and readily reproducible
system.
The diagnosis of cirrhosis is considered important
because it has serious clinical and prognostic implications
which are different from those of hepatic
fibrosis. Cirrhosis is held by most to be an irreversible
state, and instances of regression from established
cirrhosis to normal liver architecture are rare
and open to doubt. Fibrosis and chronic hepatitis are
both discussed separately at the end of the paper.
In the preparation of these guidelines, comments
and criticisms from a number of other pathologists
and hepatologists throughout the world have been
taken into account. An attempt has been made to
study a wide variety of material from different
geographical areas.
The aim of this paper is to provide guidelines forthe pathologist on the definition, nomenclature, andclassification of hepatic cirrhosis and related conditions.Many systems of classification are in currentuse in different parts of the world (Table 1). Thishinders comparisons of published data and theaccurate evaluation of relationships between cirrhosisand liver cancer. Different words have been usedto describe essentially similar features; thus ' septal ','regular ', ' uniform ', ' micronodular ', and ' monolobular'all refer to a particular morphologicalpattern of cirrhosis which is widely recognized.Conversely, a single word may be applied to a varietyof forms; for example, 'portal ' cirrhosis means onewith regular, small nodules to some, but is used byothers for any cirrhotic liver without further qualification.Another weakness of some classifications isthat they are based on a mixture of pathogenesis,morphology, and etiology (e.g. 'post-necrotic ',' portal ', and ' biliary ' cirrhosis). There is, therefore,a need for a logical and readily reproduciblesystem.The diagnosis of cirrhosis is considered importantbecause it has serious clinical and prognostic implicationswhich are different from those of hepaticfibrosis. Cirrhosis is held by most to be an irreversiblestate, and instances of regression from establishedcirrhosis to normal liver architecture are rareand open to doubt. Fibrosis and chronic hepatitis areทั้งกล่าวในตอนท้ายของกระดาษแยกต่างหากในการจัดทำแนวทางเหล่านี้ ความเห็นและวิจารณ์จาก pathologists อื่น ๆและ hepatologists ทั่วโลกได้นำมาพิจารณา ความพยายามที่ได้ทำไว้ศึกษาความหลากหลายของวัสดุจากที่อื่นพื้นที่ทางภูมิศาสตร์
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