Hello!
medical and technological progress sounds like your thing? You want to be part of a game changing reproducible scoring model? Awesome, welcome aboard this mission!
Non-alcoholic steatohepatitis is a liver disease with an increasing incidence, affecting people from all ages and with very limited therapy options. To ultimately diagnose NASH, a liver biopsy is needed and three features have to be present: 5% hepatic steatosis, lobular inflammation and ballooning. These features are usually assessed by a single pathologist for each liver biopsy. What we want to do? Train a code to score a patient’s liver sample by itself – make it objective, reproducible and easily accessible whenever needed. You are welcome to join! Please follow the next steps on this website, choose your level of experience and get started!
To make sure we are getting the most out of your results, please choose your level of knowledge in pathology.
See hints about the scores:
Steatosis
Lobular inflammation
Ballooning
Fibrosis
Steatosis
Steatosis describes the fatty change in the liver. It shows as abnromal retention of fat and counts as macrovesicular steatosis, i.e. empty holes or white round/ oval shape, which includes the lipid. Different stages of steatosis are scored as mentioned above. The higher the amount of steatosis, the worse the fatty change.
| 0 | <5% |
| 1 | 5 – 33% |
| 2 | > 33 – 66% |
| 3 | > 60% |
Lobular Inflammation
Lobular inflammation consists of inflammatory cell infiltrates, which can be lymphocytes, neutrophils, eosinophils and Kupffer cells. They usually appear in little groups and are counted on a 20x field under the microscope. In the case of this training and scoring, it will be referred to as mentioned above.
| 0 | None |
| 1 | < 2 foci/ 20x field |
| 2 | 2 – 4 foci/ 20x field |
| 3 | > 4 foci/ 20x field |
Fibrosis
Fibrosis refers to a pathological wound healing, in which connective tissue is remodeled to fibrous connective tissue and eventually irreversible scar tissue (cirrhosis). The score is determined depending on the localization of the fibrosis. Early stages of NASH usually show perisinousoidal or periportal fibrosis.
The actual score differentiates score 1 into 3 different scores depending on the localization. For ease, for the model, fibrosis score 1 will be determined by either perisinusoidal or periportal fibrosis, regardless of the localization.
| 1 |
a: Mild pericellular fibrosis b: moderate pericellular fibrosis c: portal/ periportal fibrosis without pericallular fibrosis |
| 2 | Pericellular and portal/ periportal fibrosis |
| 3 | Bridging fibrosis |
| 4 | Cirrhosis |
Ballooning
Ballooning describes the process of hepatocyte (liver cell) degeneration. It is called that way, because of the form of parenchymal cell death, in which the liver cell increases in size and looks like a „balloon“.
| 0 | None |
| 1 | Few |
| 2 | Many |