Nonalcoholic Steatohepatitis: Epidemiology, Screening, Risk Assessment, Diagnosis, and Management

  • Author: Philip N. Newsome, PhD, FRCPE (More Info)
  • Editor In Chief: Quentin M. Anstee, BSc, MB BS, PhD, MRCP(UK), FRCP
  • Last Reviewed: 8/23/19 (What's New)

Supporting Assets

Table 1 | Table 2 | Table 3 | Table 4

Table 1. Grading and Staging Systems for NAFLD and NASH[Kleiner 2005; Kleiner 2016; Bedossa 2012]

Component

Score

Score Description According to Scoring System

NAFLD Activity Score

SAF Score

Steatosis

0

< 5%

< 5%

 

1

5% to 33%

5% to 33%

 

2

33% to 66%

33% to 67%

 

3

> 66%

> 67%

Lobular Inflammation

0

No foci

None

 

1

< 2 foci/200x

≤ 2 foci/20x

 

2

2-4 foci/200x

> 2 foci/20x

 

3

> 4 foci/200x

Not applicable

Hepatocyte Ballooning

0

None

Normal hepatocytes with cuboidal shape and pink eosinophilic cytoplasm

 

1

Few balloon cells

Clusters of hepatocytes with rounded shape and pale, usually reticulated cytoplasm; similar size to normal hepatocytes

 

2

Prominent ballooning

As with grade 1 except some hepatocytes are enlarged (≥ 2x normal)

Fibrosis

0

None

None

 

1

Perisinusoidal or periportal

Perisinusoidal or periportal fibrosis

 

1A

Mild, zone 3, perisinusoidal

Not applicable

 

1B

Moderate, zone 3, perisinusoidal

Not applicable

 

1C

Portal/periportal

Not applicable

 

2

Perisinusoidal and portal/periportal

Perisinusoidal and periportal fibrosis

 

3

Bridging fibrosis

Bridging fibrosis

 

4

Cirrhosis

Cirrhosis

...

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Keywords: NAFLD