studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 917A
Disclosures:
Yasuhito Tanaka - Grant/Research Support: Chugai Pharmaceutical CO., LTD.,
MSD, Bristol-Myers Squibb; Speaking and Teaching: janssen pharma, Bristol-Myers
Squibb
The following authors have nothing to disclose: Etsuko Iio, Makoto Ocho, Akira
Togayachi, Masanori Nojima, Atsushi Kuno, Masashi Mizokami, Hiroshi Yatsuhashi,
Tatsuya Ide, Shunsuke Nojiri, Hisashi Narimatsu
1449
Second harmonic generation microscopy based quantitative
assessment for HBV-associated liver fibrosis
Kai-Wen Huang; National Taiwan University Hospital, Taipei, Taiwan
Background Liver fibrosis is associated with an abnormal
increase in an extracellular matrix in chronic liver diseases.
Quantitative characterization of collagen in intact tissue is
essential for both fibrosis studies and clinical applications.
Commonly used methods, histological staining followed by
either semi-quantitative or computerized image analysis, have
limited sensitivity, accuracy, and operator-dependent variations.
The collagen in livers could be observed through second-harmonic
generation (SHG) microscopy. The two photon
excited fluorescence (TPEF) images, recorded simultaneously
with SHG, clearly revealed the hepatocyte morphology and
associated collagen progression dynamics. Purpose To access
liver fibrosis using SHG/TPEF microscopy on human liver
biopsy and resection samples, and to identify and quantitatively
measure the morphological features, and to generate
as an index for describing the severity of fibrosis. Methods A
total of 95 specimens were sampled from patients with hepatitis
B viral infections underwent liver biopsy or liver resection
in National Taiwan University Hospital between 2010-2012.
Liver fibrosis was graded by pathologist in NTUH using the
Metavir scoring system. Quantitative analysis was also done
on the same sample using SHG/TPEF microscopy to generate
100 quantitative measurements on morphological features.
These 100 quantitative measurements are used to develop the
algorithm to fit the staging results from Metavir using non-linear
support vector machine (SVM) model. Results Out of 100 quantitative
measurements, 53 showed strong correlation with Metavir
staging and could statistically distinguish patients of stage
0 from stage 1, and 67 for distinguishing patients of stage 3
from stage 4. Out of these quantitative measurements, 10 were
selected to develop the algorithm using SVM model using half
of the data for model training, and area under curve (AUC)
generated from the remaining half samples showed 0.76 with
these 10 selected features. Conclusion Quantitative assessment
methodology combining non-stain SHG/TPEF imaging technology
and non-linear fitting model showed great correlation
with traditional pathology staging system. This process can be
automated to minimize the potential inter and intra observer
discrepancies and give highly quantitative and reproducible
results for clinical diagnosis and treatment response assessment.
Disclosures:
The following authors have nothing to disclose: Kai-Wen Huang
1450
Hepatitis C treatment and Progression of Liver Stiffness
in Australia, subsequent to the introduction of protease
inhibitors
Yang Wu 1 , Hank H. Chen 1 , Martin Weltman 1 , Guy D. Eslick 2 ,
Bilel Jideh 1 , Izabella Pokorski 1 ; 1 Gastroenterology, Nepean Hospital,
Kingswood, NSW, Australia; 2 Surgery, Nepean Hospital,
Kingswood, NSW, Australia
Background: Transient elastography (TE) is a noninvasive and
well-validated method for measurement of liver stiffness in
patients with chronic Hepatitis C. Aim: In the previous era of
interferon-based therapy, studies have shown a strong association
between Sustained Virological Response (SVR) and
improvement in Liver stiffness (LS) 1 .Our current study aims
to explore the kinetics of liver stiffness in Australian patients
receiving hepatitis C treatment including protease inhibitors, an
area not examined previously. Method: Consecutive patients at
Nepean Hospital treated for Hepatitis C from 2011 onwards
were included in the study. Patients were treated according to
standard of care for their respective genotypes, which included
protease inhibitors in patients with Genotype 1. The patient’s
initial LS measurement was taken prior to their treatment and
a second measurement was made at an interval at least 12
weeks after the end of their treatment. Other patient factors
such as gender, age, presence or absence of cirrhosis, alcoholism
and blood tests were also collated. Results: Of the 36
patients that were included in the study, 26 (72%) patients
achieved SVR. Overall, 21(58%) patients were treated with
protease inhibitors. The mean intra-patient change relative to
baseline at the follow-up elastography was -4.97 kPa in the
patient group who achieved SVR, vs +1.55 kPa in the patients
who did not achieve an SVR (p = 0.07056). In uni-variate
analysis (Mann-Whitney U test), other parameters such as protease
inhibitor use (p=0.29), viral genotype, treatment experience
(p=0.89), gender (p=0.09), age, alcohol intake (p=0.62)
and presence of cirrhosis (p=0.94) were not predictive of LS
improvement. Similarly, viral load and ALT measurement at
the start of treatment didn’t reveal any significant relationship
with post-treatment LS during Logistic regression. Conclusion:
Measurement of liver stiffness with TE after hepatitis C treatment
showed that although the SVR group had more improvement in
the liver stiffness score compared to the non-SVR group, the difference
was not statistically significant in this study. Our study
is one of the first to include patients treated with protease inhibitors.
References: Andersen ES, Moessner BK, Christensen PB,
Kjær M, Krarup H, Lillevang S, Weis N. Lower liver stiffness
in patients with sustained virological response 4 years after
treatment for chronic hepatitis C. Eur J Gastroenterol Hepatol.
2011 Jan;23(1):41-4.
Disclosures:
The following authors have nothing to disclose: Yang Wu, Hank H. Chen, Martin
Weltman, Guy D. Eslick, Bilel Jideh, Izabella Pokorski