Examination of Centrilobular Necrosis in Autoimmune Hepatitis using Bayesian Networks

Aim: Autoimmune Hepatitis (AIH) is a chronic portal-based hepatitis. Centrilobular Necrosis (CN) occasionally occurs in AIH, but the participation of CN in inflammatory processes of AIH is not clearly understood. So, in the current study, the significance of CN in AIH was examined with Bayesian Networks (BNs), comprising a newly developed statistical model. Methods and Results: Sixty AIH patients undergoing liver biopsy examination were evaluated. The significance of CN was examined with BNs using a scoring system for various histological factors, the stage, sex, and age. In all cases, interface hepatitis was present. CN occurred in 13 patients, and 4 of them had pan-acinar necrosis. BNs indicated that interface hepatitis, which became a base factor, was related to portal inflammation, plasmacytic infiltrate, rosette formation of hepatocytes, and focal necrosis, but it was not related to CN. Conclusion: In AIH, interface hepatitis-related inflammation occurs, and CN occasionally overlaps. When CN progresses to pan-acinar necrosis, a clinically serious condition occurs in the patients. CN is caused by a mechanism that differs from interface hepatitis-related inflammation. The recognition of these is useful for the diagnosis and treatment of AIH.