Is there a correlation between the CEAP score and the histopathological findings in varicose disease?

Vol. 52 No. 1 Suppl., 2011
This supplement was not sponsored by Outside Organizations.


A. Mironiuc, Laura Palcau, Liliana Rogojan, Sanda Micula, Claudia Gherman

Background: Varicose disease continues to represent an interesting subject. The factors triggering and maintaining vascular and cutaneous tissues alterations in chronic venous insufficiency are not fully known. Patients and Methods: This is a prospective, statistical analysis study, performed in a consecutive series of 40 patients with varicose disease admitted and treated at the Surgical Clinic II, Cluj-Napoca. The aim of the paper is to evidence histopathological (HP) changes in the vein wall, as well as to correlate histopathological findings, classified into stages, with the clinical stage of chronic venous insufficiency (CEAP classification). Statistical analysis was performed using the Fischer F-test for the comparison of the variances of two selections and the Student t-test for the comparison of the means. For correlation, Pearson's simple correlation coefficient was used. The software used was Excel and Matlab 7. Results: Following the statistical analysis, the mean of CEAP values was found to be higher than the mean of the histopathological stage values in all patients included in the study and in the different risk groups. The values of Pearson's linear correlation coefficient between CEAP values and histopathological stage values did not generally show a statistically significant correlation. Conclusions: CEAP classification remains the main pillar in the diagnosis and the treatment of varicose disease, even if there are some dissimilarities between the clinical appearance and the histopathological results. The presence of a correlation between histological and clinical aspects in varicose disease remains uncertain.

Corresponding author: Aurel Mironiuc, Professor, MD, PhD, e-mail:

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O. T. Pop, Corina Gabriela Cotoi, I. E. Plesea, S. D. Enache, Florina Carmen Popescu, M. A. Enache, R. M. Plesea

The study focuses on the possible influences of intra (I) lobular (L) stromal compounds [intertubular spaces and seminiferous (S) tubule (T) wall (W)] morphologic changes on S epithelium (E) during ageing process. The material consisted of surgical samples of testicular tissue from 192 patients with orchidectomy for prostate carcinoma. Seven age groups were designed, from 50 to 80 years. Tissue samples were fixed in neutral buffered formalin, embedded in paraffin stained with HE, Goldner and Gomori and immunomarked (in a subgroup of 28 cases) for smooth muscle actin, collagen IV, and CD34. SE had an uneven involution, both individually and inter-individually, but with normal spermatogenesis in many of ST. E degenerative changes were seen mainly in L periphery. Different stages of maturation arresting were more frequent in older patients. IL septae had changes with extremely variable intensity, dispersed mainly in L periphery, without significant spread and without extensive trend with ageing. Leydig cells showed focal hyperplasia without extensive trend related with ageing. STW presented strictly in the internal layer of lamina propria (apposed to basement membrane of ES) a focal sclerosis, with variable extension concerning its presence, thickness and T circumference (T without sclerosis, with focal sclerosis and with fibro-hyaline "collar" - FHyC) but not related with ageing. IL arteriolae showed focal areas of degeneration with a wide individual and inter-individual range of intensity and extension, but not related with age. Capillary network (CN), with both its peri-T and intramural segments, was present in all age groups, with no quantitative endothelial changes and decreasing only in very old cases. FHyC was often associated with E atrophy. STW focal sclerosis could explain focal degeneration of SE in senescence, although CN undergoes no significant changes.

Corresponding author: Iancu Emil Plesea, Professor, MD, PhD, e-mail:

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