Morphometric and DNA analysis in Egyptian children with chronic liver diseases

The aim of the present study was to assess the value of morphometric and DNA image analysis in the assessment of chronic liver diseases in children. Seventy liver biopsies from children with chronic liver diseases were included in the study (30 infantile cholestasis, 24 chronic hepatitis, 16 glycogen storage disease, GSD). The biopsies were examined histologically for estimation of the grade of the disease activity, stage of fibrosis, and degree of dysplasia. DNA ploidy was determined by using Feulgen's stained sections and CAS 200 image analyser. Morphometric analysis of the nuclear area, nucleo-cytoplasmatic (N/C) ratio and the degree of fibrosis (fibrotic index) were also estimated. Although the grade of disease activity was not significantly diferent among the 3 disease group, the stage of fibrosis was significantly more in the cholestatic and hepatitis group than GSD. DNA aneuploidy was observed in 8 out of 70 liver biopsies, 4 with infantile cholestisis, and 4 with chronic hepatitis. The 3 disease groups were not statistically different regarding the nuclear area or the fibrotic index. However, the N/C ratio was significantly higher in the cholestatic and hepatitis group than in GSD. Moreover, the semi-quantitative staging of fibrosis was significantly correlated with the qantitative measurement of the fibrotic index. These results suggest that image analysis especially morphometry is a helpful objective method in the investigation of chronic liver diseases in children. Liver cell dysplasia, DNA aneupoloidya, and icreased N/C ratio can be used as risk factor for developing hepatocellular carcinoma in children with chronic liver diseases either early or later in the life. Infantile cholestasis seems to have premalignant potential in Egyptian children similar to well known role of chroinic viral hepatitis.