Nonalcoholic fatty liver disease (NAFLD) activity score and the histopathologic diagnosis in NAFLD: distinct clinicopathologic meanings.
Brunt EM, Kleiner DE, Wilson LA, Belt P, Neuschwander-Tetri BA; for the NASH Clinical Research Network (CRN). Hepatology. 2011 Mar;53(3):810-820. (CUMC Full Text PDF)
Brunt EM, Kleiner DE, Wilson LA, Belt P, Neuschwander-Tetri BA; for the NASH Clinical Research Network (CRN). Hepatology. 2011 Mar;53(3):810-820. (CUMC Full Text PDF)
In this issue of Hepatology, Elizabeth Brunt and colleagues from the NASH Clinical Research Network (CRN) reiterate the fact that the NAFLD activity score (NAS) - a scoring system originally designed to serve a similar purpose as the various chronic hepatitis grading systems, or the Banff scoring system for rejection - is not an efficient substitute to traditional diagnostic criteria for NASH. As the authors point out, the composite NAS above a certain value (usually >5) has been adopted by some investigators as the basis for a diagnosis of NASH, although the validity of this approach is unproven. In this regard, the authors show that only 75% of biopsies with definite SH had an NAS >5 and that among biopsies with NAS >5, 86% had SH. They conclude that the diagnosis of NASH does not always correlate with specific threshold values of the semiquantitative NAS.
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