Accuracy of staging in primary biliary cirrhosis
Accuracy of staging in primary biliary cirrhosis
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DOI：
10.1136/jcp.49.7.556
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发表时间：
1996-07-01
影响因子：
3.4
通讯作者：
Hubscher, SG
中科院分区：
文献类型：
--
作者：
Garrido, MC;Hubscher, SG
目的：评价原发性胆汁性肝硬化（PBC）患者肝活检的取样变异性。方法：对50例PBC肝移植标本进行切片检查。纤维化的程度进行了评估的规模为0-4使用两种方法：（1）模拟穿刺活检领域的大小约为一个传统的穿刺活检;和（2）全断面扫描的区域很少和广泛的fibrosis.Results-Considerable的变化时，发现整个部分扫描方法使用的纤维化阶段的范围。只有10个（20%）样本在扫描的所有切片中具有一致的纤维化程度。相比之下，相同的纤维化阶段被分配在30个（60%）标本检查使用模拟穿刺活检方法。两种方法测定结果比较，有32个样品存在一个或两个阶段的差异。这种差异的结果是发现区域的纤维化程度较低，在整个部分相比，模拟的穿刺活检specimens. Conclusion，有相当大的变化，在PBC患者的肝脏纤维化的程度，即使在移植获得的终末期标本进行检查。当检查模拟穿刺活检标本时，获得了一致的结果。然而，这可能反映了肝穿刺活检标本分期时所采用的程序，其中最大程度的异常用于确定分期。在小针穿刺活检标本中进行PBC分期的实践是有价值的，只要谨慎解释外观，记住纤维化程度有相当大的变化。
Aims-To evaluate sampling variability of liver biopsy in patients with primary biliary cirrhosis (PBC).Methods-Sections from 50 PBC liver specimens obtained at transplantation were examined. The degree of fibrosis was assessed on a scale of 0-4 using two methods: (1) simulated needle biopsy in fields approximately the size of a conventional needle biopsy; and (2) whole section scanning in areas with little and extensive fibrosis.Results-Considerable variation in the range of stages of fibrosis was found when the whole section scanning method was used. Only 10 (20%) samples had a consistent degree of fibrosis in all sections scanned. By contrast, the same fibrosis stage was assigned in 30 (60%) specimens examined using the simulated needle biopsy method. When the results obtained by the two methods were compared, there was a discrepancy of one or two stages in 32 samples. This discrepancy was the result of discovering areas with a lesser degree of fibrosis in whole sections compared with the simulated needle biopsy specimens.Conclusion-There is considerable variation in the degree of fibrosis in the Livers of patients with PBC, even when end stage specimens obtained at transplantation are examined. Consistent results were obtained when simulated needle biopsy specimens were examined. This, however, may be a reflection of the procedure applied when staging liver needle biopsy specimens, where the greatest degree of abnormality is used in determining the stage. The practice of staging of PBC in small needle biopsy specimens is valuable as long as the appearances are interpreted with caution, bearing in mind that there is considerable variability in the degree of fibrosis.