Rom J Morphol Embryol 2011, 52(1):117–121 ORIGINAL PAPER Is there a correlation between the CEAP score and the histopathological findings in varicose disease? A. MIRONIUC 1) , LAURA PALCĂU 1) , LILIANA ROGOJAN 2) , SANDA MICULA 3) , CLAUDIA GHERMAN 1) 1) Surgical Clinic II, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca 2) Department of Pathomorphology, Emergency County Hospital, Cluj-Napoca 3) Department of Numerical and Statistical Calculus, Faculty of Mathematics and Computer Science, “Babeş-Bolyai” University, Cluj-Napoca Abstract 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. Keywords: varicose disease, CEAP classification, histological findings.  Introduction Osteoporosis varicosity is a complex venous patho- logy affecting the lower extremities. The exact etiology and physiopathology of varicose vein disease remain, however, unclear [1]. Although four theories have been put forward as potentially causative mechanisms, none yet has been established. However, there is strong evidence accumulated over the last ten years supporting the “weakening of the vein wall” theory as the initial pathogenetic mechanism [2]. The status of the long saphenous vein (LSV) recently has been investigated, because this vein is the most favorable conduit for bypass in cardiac and vascular surgery. These studies [3–8] have shown that even clinically undiseased LSVs suitable for grafting have histological changes in their walls, indicating unsuspected disease. However, all these studies are based on histological investigation of the LSV wall changes, and none of them studied these changes in relation to the CEAP classification (Clinical signs (‘C’), the various Etiologies (‘E’), Anatomical sites (‘A’) and Pathophysiological disorders (‘P’), and especially to the clinical status of this classification, which is based on objective clinical signs of chronic venous disease according to seven classes (Table 1). Table 1 – Clinical classes of the CEAP classification Class Description C0 No visible or palpable sign of venous disease. C1 Telangiectases or reticular veins. C2 Varicose veins. C3 Edema. C4 Skin changes ascribed to venous disease (pigmentation, venous eczema, lipodermatosclerosis). C5 Skin changes as defined above with healed ulcer. C6 Skin changes as defined above with active ulcer. We started this study from the premise that morpho- pathological alterations precede the clinical ones, thus advanced parietal remodeling would be more frequently found in early clinical stages. In order to demonstrate this hypothesis, the comparison between the morpho- pathological status and the clinical CEAP score is of paramount importance, especially in the view of the impact on therapy. Aim of the study If several studies [9, 10] were based on the assump- tion that a clinically non-varicose vein was normal, our R J M E Romanian Journal of Morphology & Embryology http://www.rjme.ro/