Reversal of fibrosis in patients with nonalcoholic steatohepatosis after gastric bypass surgery

BMC Obesity

Table 4 Liver Biopsy test components for patients who had biopsies both before and after RYGB (N = 15)

	Pre-Op RYGB					Post-OP RYGB
	Lobular		Hepatocyte			Lobular		Hepatocyte
Pt #	Steatosis	Inflammation	Balloon	Fibrosis^a	Overall^b	Steatosis	Inflammation	Balloon	Fibrosis^a	Overall^b
26	<5%	No foci	None	3	Normal	<5%	No foci	None	1C	Normal
29	<5%	No foci	None	2	Normal	<5%	No foci	None	2	Normal
38	5–33%	<2 foci/200×	None	1C	NAFL	<5%	No foci	None	0	Normal
4	>66%	<2 foci/200×	Many cells/ prominent ballooning	3	NASH w Fibrosis	5–33%	2–4 foci/200×	Few Balloon Cells	3	NASH w Fibrosis
20	5–33%	<2 foci/200×	Few balloon cells	1B	NASH	<5%	No foci	None	0	Normal
27	>33–66%	<2 foci/200×	Few balloon cells	2	NASH	<5%	No foci	None	1C	Normal
33	>33–66%	<2 foci/200×	Many cells/ prominent ballooning	3	NASH w Fibrosis	<5%	<2 foci/200×	Few Balloon Cells	2	Normal
44	>66%	2–4 foci/200×	Few balloon cells	1A	NASH	<5%	No foci	None	0	Normal
47	5–33%	<2 foci/200×	Few balloon cells	2	NASH	<5%	No foci	None	1C	Normal
50	5–33%	2–4 foci/200×	Few balloon cells	2	NASH	<5%	No foci	None	1C	Normal
60	33–66%	2–4 foci/200×	Few balloon cells	1A	NASH	5–33%	<2 foci/200×	None	1C	NAFL
72	5–33%	No foci	Few balloon cells	2	NASH	>33–66%	<2 foci/200×	Few Balloon Cells	1B	NASH
79	>33–66%	<2 foci/200×	Few balloon cells	1A	NASH	5–33%	<2 foci/200×	None	0	NAFL
83	>33–66%	>4 foci/200×	Few balloon cells	1A	NASH	<5%	No foci	None	0	Normal
102	5–33%	<2 foci/200×	Few balloon cells	1A	NASH	<5%	No foci	None	0	Normal

NAFL Nonalcoholic fatty liver, NASH Nonalcoholic Steatohepatitis, RYGB Roux-en-Y gastric bypass
^aFibrosis score: 0 – None; 1 - Perisinusoidal or periportal; 1A - Mild, zone 3, perisunsoidal; 1B - Moderate, zone 3, perisinusoidal; 1C - Portal/periportal; 2 -₂₈Perisinusoidal and portal/periportal; 3 - Bridging fibrosis; and 4 – Cirrhosis
^bWe grouped patients into one of the following four liver disease categories based on their histological measures prior to surgery: (1) normal liver defined as steatosis <5%, (2) nonalcoholic fatty liver (NAFL) defined as steatosis >5% without any ballooning cells and lobular inflammation <2 foci per 200 X magnification field, (3) nonalcoholic steatohepatitis (NASH) defined as steatosis >5% with at least a few balloon cells and lobular inflammation >2 foci per 200 X magnification field and no fibrosis or stage 1 or 2 fibrosis, and (4) NASH and fibrosis defined as steatosis >5% with at least a few balloon cells and lobular inflammation >2 foci per 200 X magnification field and stage 3 or 4 fibrosis

ISSN: 2052-9538