Table 7.

The system of semi-quantitative assessment of the liver morphopathological lesions elaborated by Ishak (1995)

Necroinflammatory activity								Fibrosis
Periportal or preseptal interface hepatitis (piecemeal necrosis)	Score	Confluent necrosis	Score	Focal (spotty) lytic necrosis apoptosis and focal inflammation	Score	Portal inflammation	Score	Fibrosis	Score
Absent	0	Absent	0	Absent	0	Absent	0	No fibrosis	0
Mild (focal, few portal areas)	1	Focal confluent necrosis	1	One focus or less per ×10 objective	1	Mild, some or all portal areas	1	Fibrous expansion of some portal areas, with or without short fibrous septa	1
Mild (focal, few portal areas)	2	Zone 3 necrosis in some areas	2	Two to four foci per ×10 objective	2	Moderate, some or all portal areas	2	Fibrous expansion of most portal areas, with or without short fibrous septa	2
Moderate (continuous around <50% of tracts or septa)	3	Zone 3 necrosis in most areas	3	Five to 10 foci per ×10 objective	3	Moderate/marked, all portal areas	3	Fibrous expansion of most portal areas, with occasional portal to portal bridging	3
Severe (continuous around >50% of tracts or septa)	4	Zone 3 necrosis + occasional portal-central (P-C) bridging	4	More than 10 foci per ×10 objective	4	Marked, all portal areas	4	Fibrous expansion of most portal areas, with marked bridging (portal to portal as well as portal to central)	4
		Zone 3 necrosis + multiple P-C bridging	5					Marked bridging with occasional nodules (incomplete cirrhosis)	5
		Panacinar or multiacinar necrosis	6					Cirrhosis, probable or definite	6