Diagnostics of Fibrosis in Alcoholic Liver Damage

Aim. In this article, the authors determine the severity (index) of histological activity (HAI) and fi brosis in various forms of alcoholic liver disease drawing on the autopsy material, as well as suggest a marker for detecting fi brosis.

Materials and methods. The authors studied 110 autopsies and histopathological studies of people who died from ethanol poisoning in the setting of various forms of alcoholic liver damage (95) and traumatic brain injury – control (15). Alcohol dehydrogenase (ADH) activity was studied through histochemical methods; values were estimated through the quantitative morphometry of the histochemical reaction product using the MORFOLOG program developed at the Department for Forensic Medicine (V.A. Porodenko, 1996). Statistical analysis was performed using the STATISTICA 10 software package and a created Exсel database. In order to determine the signifi cance between two compared values, the Student’s t-test was employed. Correlations were estimated using the Spearman’s rank correlation coeffi cient (r).

Results. The study revealed various degrees of histological activity and fi brosis in the setting of alcoholic steatosis, hepatitis and cirrhosis. The initial liver damage is characterised by minimal / weak activity and F0–F2 stage of fi brosis. With the progression of the pathological process in the liver, HAI is estimated as moderate and severe (F2–F4 stage of fi brosis). There is a correlation between the development of perisinusoidal and pericellular fi broses (r = –0.655), septae (r = –0.435), connective tissue in the portal tracts and around a vein (r = –0.517) and the number of medium caliber vessels in the liver, as well as between the portal vein diameter and the development of perisinusoidal and pericellular fi broses (r = 0.377). The authors noted high and moderate positive correlation between the ADH activity in zone 3 of the liver acini and the development of necroses and fi brosis, minor cholestases, expansion of the perisinusoidal spaces. The calculated index of fi brosis and ischemic liver damage correlates with its impaired morphofunctional state.

Conclusion. The obtained data indicate that fi brosis develops in the early stages of alcoholic liver damage, whose severity can be assessed using the proposed method for determining the index of fi brosis and ischemic liver damage, given that it refl ects both the structural and functional state of the organ.