The relationship between collagen proportionate area and Hepatitis B surface antigen levels in e antigen positive hepatitis B cirrhosis

Background: Quantitative serum HBsAg has been widely used as a biomarker for treatment response and prognosis in chronic hepatitis B, and recently been found associated with liver histology in HBeAg positive patients. Collagen proportionate area (CPA) as a continuous variable is a appropriate histological measurement to assess the degree of fibrosis and substages cirrhosis. We aimed to explore the association of serum HBsAg level with CPA in e antigen positive hepatitis B cirrhosis.Methods: Liver fibrosis staging was evaluated semiquantitatively according to the Metavir scoring system, only patients with METAVIR stage 4 were included. All liver biopsies were restained with picroSirius red for collagen quantification and determination of CPA by digital image analysis.Results: Mean collagen proportionate area value was 23.46%. The percentage of patients with different classification of CPA (< 20%, 20%-30%, >30%) were 25.8%, 57.8%, and 16.4%, respectively. A modest correlation was observed between CPA and serum HBsAg (r = -0.306, p = 0.001). HBsAg level is independently associated with collagen proportionate area in multivariable linear regression analyses.Conclusion: Serum HBsAg levels can predict liver fibrosis determined by CPA in e antigen positive hepatitis B cirrhosis.

Extra-axonal restricted diffusion as an in-vivo marker of reactive microglia

Reactive microgliosis is an important pathological component of neuroinflammation and has been implicated in a wide range of brain diseases including brain tumors, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, and schizophrenia. Mapping reactive microglia in-vivo is often performed with PET scanning whose resolution, cost, and availability prevent its widespread use. The advent of diffusion compartment imaging (DCI) to probe tissue microstructure in vivo holds promise to map reactive microglia using MRI scanners. But this potential has never been demonstrated. In this paper, we performed longitudinal DCI in rats that underwent dorsal root axotomy triggering Wallerian degeneration of axons—a pathological process which reliably activates microglia. After the last DCI at 51 days, rats were sacrificed and histology with Iba-1 immunostaining for microglia was performed. The fraction of extra-axonal restricted diffusion from DCI was found to follow the expected temporal dynamics of reactive microgliosis. Furthermore, a strong and significant correlation between this parameter and histological measurement of microglial density was observed. These findings strongly suggest that extra-axonal restricted diffusion is an in-vivo marker of reactive microglia. They pave the way for MRI-based microglial mapping which may be important to characterize the pathogenesis of neurological and psychiatric diseases.

Retraction of cutaneous specimens: tumours and margins after surgical excision

AimsIn previous studies, skin retraction of dermato-pathological specimens after the surgical excision of tumours was calculated at 30% for the surface, with approximately 20% for the length and 15% for the width. The aim of this study was to analyse the retraction of the specimens and the retraction of the lesion and the margins.MethodsPatients who underwent excision of a skin tumour between January 2013 and July 2014 were randomly included.ResultsA total of 104 patients was included. There were 52% male with a mean age of 68.3 years. Seventy-eight per cent of the lesions were malignant (51% were basal cell carcinoma, 10% squamous cell carcinoma). The retraction of the area of the specimen (29%) was significantly greater than the retraction of the tumour (21%). On multivariate analysis, the localisation and the duration of fixation were independent predictors of the specimen area retraction. The retraction of the specimen was 17% in length and 15% in width. The retraction of the margins was calculated at 19% in length and 12% in width. The surgeon correctly evaluated the localisation of the smallest margin in 55% of cases.ConclusionsOur study provided additional data regarding the retraction of the tumours and margins. The guidelines for surgical excision of skin cancers recommend a clinical margin before excision, but the evaluation of the sufficiency of the margins is based on histological measurement. Our data are useful for the interpretation of the sufficiency of the margins.