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NASH (nonalcoholic steatohepatitis) scoring system

2015年9月21日

Terminology:

NAFLD: Nonalcoholic fatty liver disease.

NASH:nonalcoholic steatohepatitis. NASH is the progressive form of NAFLD.

 

Matteoni terminology

type 1 fatty liver alone simple fatty liver fatty liver
type 2 fat accumulation+lobular inflammation steatohepatitis fatty liver
type 3 fat accumulation+ballooning degeneration steatonecrosis NASH
type 4

fat accumulation+ballooning degeneration+Mallory hyaline or fibrosis

 steatonecrosis+Mallory body or fibrosis NASH

Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ: Nonalchoholic fatty liver disease: A spectrum of clinical and pathological severity. Gastroenterology, 116; 1413-1419, 1999.

■NAS SCORE

NAS: NAFLD Activity Score

NASH Clinical Research Network Scoring System
  Item Definition Score/Code
 
NAS Steatosis Low- to medium-power evaluation of parenchymal  involvement by steatosis  
  <5% 0
  5%-33% 1
  >33%-66% 2
  >66% 3
     
     
Lobular inflammation Overall assessment of all inflammatory foci  
  No foci 0
  <2 foci per 200x field 1
  2-4 foci per 200x field 2
  >4 foci per 200x field 3
     
Hepatocyte ballooning    
  None 0
  Few balloon cells 1
  Many cells/prominent ballooning 2
max 8 points
Fibrosis    Stage    
  None 0
  Perisinusoidal or periportal 1
  　　Mild, zone 3, perisinusoidal 1A
  　　Moderate, zone 3, perisinusoidal 1B
  　　Portal/periportal 1C
  Perisinusoidal and portal/periportal 2
  Bridging fibrosis 3
  Cirrhosis 4

 

Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, Ferrell LD, Liu YC, Torbenson MS, Unalp-Arida A, Yeh M, McCullough AJ, Sanyal AJ; Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005 Jun;41(6):1313-21.

 

執筆日：2006.7.20　→　2011.10.21追記

執筆者：北海道大学病院病理部（現　神戸大学病院病理部）　伊藤　智雄　itoh@spatho.med.hokudai.ac.jp →　tomitoh@med.kobe-u.ac.jp

（追記）神戸大学医学部附属病院病理診断科　竹内真衣、伊藤智雄

 

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