{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T23:09:59Z","timestamp":1772492999380,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T00:00:00Z","timestamp":1509062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2017,11]]},"abstract":"Non\u2010alcoholic fatty liver disease (NAFLD<\/jats:styled-content>) is an increasingly common cause of chronic liver disease. Till date, liver biopsy remains the gold standard for identification and quantification of the wide histological spectra ofNAFLD<\/jats:styled-content>. Histological scorings are very useful and widely applied for the diagnosis and management in clinical trials and follow\u2010up studies of non\u2010alcoholic steatohepatitis (NASH<\/jats:styled-content>). However, in view of scarce published literature, there is a need to evaluate them in large cohort ofNAFLD<\/jats:styled-content>. This study was aimed to evaluate the two histological scoring systems (NAS<\/jats:styled-content>\u2010CRN<\/jats:styled-content>,SAF<\/jats:styled-content>) in the diagnosis ofNAFLD<\/jats:styled-content>and to assess the role of histological characteristics as injury markers inNAFLD<\/jats:styled-content>. Retrospective histological study of liver biopsies of 1000 patients diagnosed asNAFLD<\/jats:styled-content>, between 2010 and 2016, was conducted. Histopathologic evaluation and semiquantiative scoring based onNAS<\/jats:styled-content>\u2010CRN<\/jats:styled-content>andSAF<\/jats:styled-content>algorithm and their correlation with serum aminotransferase and fibrosis were performed. Liver biopsies were classified according to theNAS<\/jats:styled-content>\u2010CRN<\/jats:styled-content>scoring, asNAS<\/jats:styled-content><3 (notNASH<\/jats:styled-content>) in 72 (7.2%),NAS<\/jats:styled-content>3\u20134 (borderlineNASH<\/jats:styled-content>) in 310 (31%), andNAS<\/jats:styled-content>\u22655 (definiteNASH<\/jats:styled-content>) in 618 (61.8%), andSAF<\/jats:styled-content>classified 117 (11.7%) notNASH<\/jats:styled-content>and 883 (88.3%) definiteNASH<\/jats:styled-content>. There was excellent concordance for definiteNASH<\/jats:styled-content>and notNASH<\/jats:styled-content>; however, 88.06% of borderlineNASH<\/jats:styled-content>was classified asNASH<\/jats:styled-content>bySAF<\/jats:styled-content>. 76.39% byNAS<\/jats:styled-content>and 78.63% bySAF<\/jats:styled-content>algorithm who were diagnosed as notNASH<\/jats:styled-content>showed the presence of fibrosis; however, higher stages of fibrosis were significantly more prevalent in definiteNASH<\/jats:styled-content>, excluding burnt\u2010out cirrhosis. SerumALT<\/jats:styled-content>was significantly associated with increasing stages of fibrosis (p\u00a0<\u00a00.001) and the three categories (notNASH<\/jats:styled-content>, borderlineNASH<\/jats:styled-content>, and definiteNASH<\/jats:styled-content>) when classified as with\/without fibrosis (p\u00a0<\u00a00.001). Steatosis of higher grades, more ballooned cells, and more foci of Lobular Inflammation were found in significantly higher proportion of patients withNASH<\/jats:styled-content>(p\u00a0<\u00a00.001), with higher fibrosis stages (p\u00a0<\u00a00.001) and higher serumALT<\/jats:styled-content>levels (p\u00a0<\u00a00.001).NAFLD<\/jats:styled-content>classifications based on histological scoringNAS<\/jats:styled-content>\u2010CRN<\/jats:styled-content>andSAF<\/jats:styled-content>algorithm are concordant for the category of definiteNASH<\/jats:styled-content>and notNASH<\/jats:styled-content>, while borderlineNASH<\/jats:styled-content>shows discrepant interpretation. There was highly significant correlation between theNAS<\/jats:styled-content>andSAF<\/jats:styled-content>categories with high grades of histological characteristics, with serumALT<\/jats:styled-content>and with higher stages of fibrosis. Exclusion of fibrosis is a limitation with both scores.<\/jats:p>","DOI":"10.1111\/apm.12742","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T10:48:58Z","timestamp":1509101338000},"page":"962-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Non\u2010alcoholic fatty liver disease \u2013 histological scoring systems: a large cohort single\u2010center, evaluation study"],"prefix":"10.1111","volume":"125","author":[{"given":"Archana","family":"Rastogi","sequence":"first","affiliation":[{"name":"Department of Pathology Institute of Liver & Biliary Sciences Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saggere Muralikrishna","family":"Shasthry","sequence":"additional","affiliation":[{"name":"Department of Hepatology Institute of Liver & Biliary Sciences Delhi 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