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发表于 2003-7-30 03:53
J Hepatol. 2003 Aug;39(2):239-44. Links
Impact of liver biopsy size on histological evaluation of chronic viral
hepatitis: the smaller the sample, the milder the disease.
Colloredo G, Guido M, Sonzogni A, Leandro G.
Liver Unit, Seriate Hospital, Bergamo, Italy
BACKGROUND/AIMS: In chronic viral hepatitis, liver biopsy is performed for
assessing disease activity and fibrosis. In this study, we evaluated the
impact of the size of liver biopsy on the grading and staging.METHODS: We
selected 161 liver biopsies from patients with chronic types B and C
hepatitis on the basis of their length (>/=3 cm) and width (1.4 mm). Ishak
scoring system was used for grading and staging. The score was blindly
repeated reducing the length of the specimen from >/=3 to 1.5 cm and to 1 cm
long and width from 1.4 to 1 mm.RESULTS: Reducing the length of the biopsy
led to an increase of cases with mild grades: 49.7% in >/=3 cm, 60.2% in 1.5
cm and 86.6% in 1 cm long specimens (P<0.001). Similarly, cases staged as
having mild fibrosis significantly increased in the shorter specimens: 59%
in >/=3 cm, 68.3% in 1.5 cm and 80.1% in 1 cm long specimens (P<0.001). As
for the width, both grade and stage were significantly underscored in the 1
mm samples, regardless of their length.CONCLUSIONS: Liver biopsy size
strongly influences the grading and staging of chronic viral hepatitis. The
use of fine needles should be discouraged in this setting.
PMID: 12873821 [PubMed - in process]
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