DETECTION OF EARLY ZONE 3 LIVER FIBROSIS IN CHRONIC ALCOHOLICS A Comparison of Four Connective Tissue Staining Methods

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Abstract
Fibrous deposits in the perisinusoidal space in the acinar zone 3 are early and prognostically important features of the alcoholic liver lesion. Four connective tissue staining methods: van Gieson''s Picro-Fuchsin (VG), Gordon and Sweets'' reticulin (GS), Chromotrope Aniline Blue (CAB), and Picro-Sirius (PS) were evaluated concerning their relative sensitivity in the detection of early zone 3 fibrosis. A selected area in 60 liver biopsies with preserved architecture, obtained from chronic alcoholics, were studied. A semiquantitative registration of the degree of fibrosis was made. A comparison between the scores of the various staining methods by means of Pratt''s test revealed PS to be significantly the most sensitive method. GS was insignificantly more sensitive than CAB while VG (which in contrast to the other three methods leaves reticulin unstained) was the least sensitive. In five biopsies which only revealed fibrosis in PS, perisinusoidal collagenization was confirmed by transmission electron microscopy. In the histological detection of early zone 3 fibrosis, PS is therefore recommended.

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