Razi Journal of Medical Sciences

    Background & Aim: Chronic hepatitis is a common liver disease which can be caused by various viral and non-viral agents. The chronic hepatitis prevalence is high in Iran. After 50 years of introducing this disease, yet there is unknown etiology in some cases. The aim of the present study was to determine the frequency of pathology findings regarding Ishak system in chronic cirrhosis patients in order to have an accurate diagnosis and more appropriate clinical decision making. Patients & Methods: This observational cross-sectional study was performed on biopsy samples related to 40 chronic hepatitis and cirrhosis patients admitted to Rasoul-e-Akram Hospital from 1997 to 2002. These samples were scored according to modified Ishak system. Chi-square test, one way ANOVA and K.S were used for analyzing the data. Results: Patients’ mean age was 51.1 3.3(42.1% female and 57.9% male). Grading and staging of biopsy samples regarding Ishak system were as follows: 7 patients(pts.) (17.5%) minimal chronic hepatitis (grades 0, 1), 15 pts. (37.5%) mild chronic hepatitis (grades 2-6), 7 pts. (17.5%) moderate chronic hepatitis (grades 7-11), 10 pts. (25%) severe chronic hepatitis (grades 12-16), 1 pt. (2.5%) active cirrhosis (grades 17, 18), 8 pts. (20%) stage0, 8 pts. (20%) stage1, 5 pts. (12.5%) stage2, 9 pts. (2.5%) stage3, 4 pts. (10%) stage4, 5 pts. (12.5%) stage5 and 1 pt. (2.5%) stage6. In analytic assessment there was significant statistical association between staging and grading of disease (P=0.000). Also, staging and grading of disease had statistical relation with hepatic encephalopathy, history of ascitis and increasing age of patients. (P<0.05). Conclusion: Clinical importance of scoring system reveals itself when physicians and specialists face problem in diagnosing some diseases. The use of Ishak scoring system is suggested for evaluating chronic hepatitis in order to have appropriate diagnosis and monitoring treatment.