Histopathological analysis of liver fibrosis using the ISHAK staging system: A 5-year study

Background: Liver fibrosis is a progressive pathological condition resulting from chronic liver injury and is a major determinant of morbidity and mortality in chronic liver diseases. Histopathological assessment remains the gold standard for staging fibrosis. Aims and Objectives: The aim of the study was to evaluate the stages of liver fibrosis in biopsy specimens using the Ishak Fibrosis Scoring System (ISHAK) staging system and compare it with the META-analysis of VIRal hepatitis (METAVIR) staging system. The study also aims to correlate stages of fibrosis with liver function test (LFTs) parameters and to analyze the histomorphological spectrum of hepatic lesions. Materials and Methods: This retrospective and prospective study included 83 liver biopsy cases over a period of 5 years. Histological evaluation was performed using routine and special stains. Fibrosis staging was done using the ISHAK system and compared with METAVIR staging. Results: The majority of patients were in the 51–60 years age group (28.92%) with male predominance (61.45%). Fibrosis was the most common histological finding (90.36%). Most cases were in advanced stages, with ISHAK stage 5 (28.91%) and stage 6 (19.28%). Strong correlation was observed between ISHAK and METAVIR staging systems. LFTs showed progressive elevation with advancing fibrosis stage. Conclusion: The ISHAK staging system is a reliable and detailed method for assessing liver fibrosis. Late-stage presentation highlights the need for early diagnosis and intervention.