Study of liver in HBV-related hepatocellular carcinoma: Stereology shows quantitative differences in liver structure

Study of liver in HBV-related hepatocellular carcinoma: Stereology shows quantitative differences in liver structure
Bita Moudi ,^1,* Zahra Heidari,² Hamidreza Mahmoudzadeh-Sagheb,³
1. Zahedan University of Medical Sciences, Infectious Diseases and Tropical Medicine Research Center, and Department of Histology.
2. Zahedan University of Medical Sciences, Infectious Diseases and Tropical Medicine Research Center, and Department of Histology.
3. Zahedan University of Medical Sciences, Infectious Diseases and Tropical Medicine Research Center, and Department of Histology.
Introduction: Hepatocellular carcinoma is one of the main consequences of liver chronic disease. Hepatocellular carcinoma-related changes may be seen in patients with chronic hepatitis B. The aim of the current study was to quantitate liver tissue elements by stereological technique in patients with hepatitis B-related cancer and compare the results with control and only hepatitis B group. Needle liver biopsies from 40 patients with only chronic hepatitis B infection, from 41 patients with only early hepatocellular carcinoma, from 40 patients with early hepatitis B-related cancer and 30 healthy subjects (control group) were analyzed by stereological method using systematic uniform random sampling method. Haematoxylin and eosin stained sections were used. The numerical density of hepatocytes, hepatocyte volume, numerical density of Kupffer cells, volume density of the connective tissue in the portal space, and volume density of the connective tissue were assessed. Quantitative analysis of liver samples indicated that there were statistically significant differences in the numerical density of hepatocytes, hepatocyte volume, numerical density of Kupffer cells, volume density of the connective tissue in the portal space, and volume density of the connective tissue between control and hepatitis B-related cancer and hepatitis B groups. Quantitative, stereological technique is simple and reliable for evaluating HCC in chronic hepatitis B. It is useful for assessing the liver tissue parameters. Stereology is recommended for the diagnosis of people prone to cancer in patients with chronic hepatitis B.
Methods: Needle liver biopsies from 40 patients with only chronic hepatitis B infection, from 41 patients with only early hepatocellular carcinoma, from 40 patients with early hepatitis B-related cancer and 30 healthy subjects (control group) were analyzed by stereological method using systematic uniform random sampling method. Haematoxylin and eosin stained sections were used. The numerical density of hepatocytes, hepatocyte volume, numerical density of Kupffer cells, volume density of the connective tissue in the portal space, and volume density of the connective tissue were assessed.
Results: Current study has shown the application of the stereology in diagnosis of HCC susceptible patients with HBV. This method can be used to study the changes in liver tissue when using a new treatment. Also, stereological parameters can follow up patients with chronic hepatitis B. Quantitative analysis of liver samples indicated that there were statistically significant differences in the numerical density of hepatocytes, hepatocyte volume, numerical density of Kupffer cells, volume density of the connective tissue in the portal space, and volume density of the connective tissue between control and hepatitis B-related cancer and hepatitis B groups. Quantitative, stereological technique is simple and reliable for evaluating HCC in chronic hepatitis B.
Conclusion: Consequently, stereology is a simple and reliable quantitative technique for the measurement of liver elements such as the number of hepatocytes and Kupffer cells and volume density of the connective tissue in different aria of the liver in patients with chronic hepatitis B. Also, it can assess the fibrosis in biopsy specimen. We recommend this method as one of the most important tools for follow up of patients because it has a high reproducibility in intra field assessment and low intra observer variability. We hope that the results elicited by the present study can be translated into improving the diagnosis conditions for populations worldwide, especially for those individuals living in poor and developing countries.
Keywords: Hepatocellular carcinoma, hepatitis B, stereology