Staging of liver fibrosis or cirrhosis: The role of hepatic venous pressure gradient measurement

Table 1 Scoring system of liver fibrosis in liver biopsy

	Score
METAVIR score	0	1	1	2	3	4	4
	No fibrosis	Portal fibrosis without septa	Portal fibrosis without septa	Septal fibrosis (portal-portal)	Septal fibrosis (portal-central)	Cirrhosis	Cirrhosis
Ishak score		1	2	3	4	5	6
	No fibrosis	Some portal tract fibrotic ± short fibrous septa	Most portal tract fibrotic ± short fibrous septa	Portal tract fibrotic with occasional portal to portal bridging	Portal tract fibrotic with marked portal to portal and portal to central bridging	Marked portal to portal and/or portal to central with occasional nodules	Cirrhosis

Table 2 Pathologic, hemodynamic, and clinical stage of liver fibrosis

Classification	Stages
METAVIR score	F0-F3	F4	F4	F4	F4
HVPG (mmHg)		> 6	> 10	> 12	> 16 > 20
Clinical class		Stage 1	Stage 2	Stage 3	Stage 4-5
		Compensated	Compensated	Decompensated	Decompensated
			Varices	Varices Ascites	Variceal bleeding Ascites Other complications
1-yr mortality (%)		1	3	10-30	60-100

This table was modified from ref.[54]. HVPG: Hepatic venous pressure gradient.