Quaglia A, Jutand M, Dhillon A, Godfrey A, Togni R, Bioulac-Sage P, Balabaud C, Winnock M, Dhillon A. Classification tool for the systematic histological assessment of hepatocellular carcinoma, macroregenerative nodules, and dysplastic nodules in cirrhotic liver. World J Gastroenterol 2005; 11(40): 6262-6268 [PMID: 16419153 DOI: 10.3748/wjg.v11.i40.6262]
Corresponding Author of This Article
Dr. A Quaglia, Department of Histopathology, Royal Free Hospital, Pond Street, London NW3 2QG, United Kingdom. alberto.quaglia@kingsch.nhs.uk
Article-Type of This Article
Liver Cancer
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Table 3 Classification tool for hepatocellular lesions in cirrhotic liver. Assess each individual histological feature (as per Table 1) and go to Table 4a
Column 1
Column 2
Column 3
Column 4
HCC
DN or MRN
DN
MRN
Vascular invasion not present
Capillarization score 3, 4, or 5
Capillarization score 0, 1, or 2
Capsular invasion not present
Cellular atypia score 1, 2, 3, 4, or 5
Cellular atypia score 0
Necrosis present
Necrosis not present
Reticulin loss score 1, 2, 3, 4, or 5
Reticulin loss score 0
Mitosis present
Mitosis not present
Trabecular thickness >3
Trabecular thickness <4
Capillarization score 4 or 5
Capillarization Score 0, 1, 2 or 3
Solitary arterioles ≥1
Solitary arterioles <1
Cellular atypia score 3, 4, or 5
Cellular atypia score 0, 1, or 2
Heterogeneity present
Heterogeneity absent
Reticulin loss score 1, 2, 3, 4, or 5
Reticulin loss score 0
Necrosis present
Trabecular thickness>3
Trabecular thickness<4
Mitosis present
Solitary arterioles ≥1
Solitary arterioles<1
Heterogeneity present
Heterogeneity absent
Table 2 MCA of the values of the histological variables in the three categories (HCC, MRN, and DN) in the exploratory set of 212 hepatocellular nodules in cirrhotic livers
Position
Feature
Grade
HCC number (total 106)
%
DN number (total 32)
%
MRN number (total 74)
%
1
Vascular invasion
Present
27
25.5
0
0
0
0
2
Necrosis
Present
17
16
0
0
0
0
3
Capsular invasion
Present
44
41.5
0
0
0
0
4
Cellular atypia
4-5
30
28.3
0
0
0
0
5
Trabecular thickness
>4
35
33
1
3
0
0
6
Mitosis
Any
50
47.2
0
0
0
0
7
Reticulin loss
4-5
47
44.3
0
0
0
0
8
Capillarization
5
56
52.8
0
0
0
0
9
Cellular atypia
3
38
35.8
0
0
0
0
10
Solitary arterioles
>2
23
21.7
1
3
1
1
11
Trabecular thickness
4
27
25.5
3
9
0
0
12
Capillarization
4
27
25.5
1
3
0
0
13
Solitary arterioles
2
37
34.9
5
15
1
1
14
Heterogeneity
Present
100
94.3
23
72
5
7
15
Reticulin loss
1-3
56
52.8
9
28
2
3
16
Solitary arterioles
1
33
31.1
7
22
10
14
17
Capillarization
3
19
17.9
8
25
2
3
18
Trabecular thickness
<4
44
41.5
27
84
72
97
19
Cellular atypia
1-2
37
34.9
12
38
16
22
20
Necrosis
Not present
89
84
32
100
74
100
21
Vascular invasion
Not present
79
74.5
32
100
74
100
22
Capsular invasion
Not present
62
58.5
32
100
74
100
23
Mitosis
Not present
56
52.8
32
100
74
100
24
Solitary arterioles
<1
13
12.3
19
59
62
84
25
Capillarization
0–2
4
3.8
23
72
72
97
26
Cellular atypia
0
1
0.9
20
63
58
78
27
Heterogeneity
Not present
6
5.7
9
28
69
93
28
Reticulin loss
0
3
2.8
23
72
72
97
Table 4 Performance of the classification tool on a second validation set of liver cell nodules in cirrhotic livers
Citation: Quaglia A, Jutand M, Dhillon A, Godfrey A, Togni R, Bioulac-Sage P, Balabaud C, Winnock M, Dhillon A. Classification tool for the systematic histological assessment of hepatocellular carcinoma, macroregenerative nodules, and dysplastic nodules in cirrhotic liver. World J Gastroenterol 2005; 11(40): 6262-6268