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

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

  Pre-Op RYGB Post-OP RYGB
  Lobular Hepatocyte   Lobular Hepatocyte  
Pt # Steatosis Inflammation Balloon Fibrosisa Overallb Steatosis Inflammation Balloon Fibrosisa Overallb
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
  1. NAFL Nonalcoholic fatty liver, NASH Nonalcoholic Steatohepatitis, RYGB Roux-en-Y gastric bypass
  2. 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
  3. 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