Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease
Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease
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DOI：
10.1016/s0168-8278(03)00191-0
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发表时间：
2003-08-01
影响因子：
25.7
通讯作者：
Leandro, G
中科院分区：
文献类型：
--
作者：
Colloredo, G;Guido, M;Leandro, G
背景/目的：在慢性病毒性肝炎中，肝活检用于评估疾病活动性和纤维化。在这项研究中，我们评估了肝活检的大小对分级和分期的影响。方法：选择161例慢性乙型和丙型肝炎患者的肝活检组织，根据其长度（大于或等于3cm）和宽度（1.4 mm）。Ishak评分系统用于分级和分期。将标本长度从大于或等于3 cm减少到1.5 cm，长度从1.4 mm减少到1 cm，宽度从1 mm减少到1 cm，盲目重复评分。结果：减少活检长度导致轻度分级的病例增加：大于或等于3 cm的病例增加49.7%，1.5 cm的病例增加60.2%，1 cm的病例增加86.6% （P < 0.001）。同样，在较短的标本中，轻度纤维化的病例显著增加：>= 3 cm的病例占59%，1.5 cm的病例占68.3%，1 cm的病例占80.1% （P < 0.001）。至于宽度，在1毫米的样品中，无论其长度如何，品位和阶段都得到了显著的强调。结论：肝活检大小对慢性病毒性肝炎的分级和分期有很大影响。在这种情况下不鼓励使用细针。(C) 2003年欧洲肝脏研究协会。Elsevier Science B.V.版权所有。
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 (greater than or equal to3 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 greater than or equal to 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 greater than or equal to 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 I cm long specimens (P < 0.001). As for the width, both grade and stage were significantly underscored in the I 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. (C) 2003 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.