Inter-observer variability in histopathological assessment of liver biopsies taken in a pediatric open label therapeutic program for chronic HBV infection treatment.
OBJECTIVE
To our knowledge, the inter-observer variability of the liver biopsy findings in HBV-infected children have not been studied as yet. Hence, we aimed to compare different pathologist's assessment of grading and staging in liver biopsies obtained from children prior to interferon treatment.


METHODS
We collected 920 biopsies from 11 medical centers. The biopsies were independently reviewed by 6 pathologists from academic centers who assessed Batts-Ludwig score for grading and staging. Satisfactory agreement among observers was defined as at least 60% of observers having the same opinion. Satisfactory dispersion between maximal and minimal score for the same biopsy specimen was defined as a maximum 1 point.


RESULTS
Satisfactory inter-observer agreement for grading was obtained in 51.6% and for staging in 75.7% of biopsies. Satisfactory dispersion for grading scores was observed in 44.5% and for staging in 72.7% of cases.


CONCLUSIONS
Our study demonstrates that: (1) pathologists differ in their assessment of grading and staging of liver biopsies; (2) inter-observer variability for staging is lower than that for grading; and (3) regardless of the inter-observer variability of assessments, the majority of children with chronic HBV infection have mild to moderate inflammation and mild to moderate fibrosis.
Department of Gastroenterology, Hepatology and Immunology, Children's Health Memorial Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland. m.woynarowski@med-net.pl
Marek
M
Woynarowski
Joanna
J
Cielecka-Kuszyk
Andrzej
A
Kałuzyński
Aleksandra
A
Omulecka
Maria
M
Sobaniec-Łotowska
Julian
J
Stolarczyk
Wojciech
W
Szczepański
D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000473:pathology; D007372:Interferons / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index
D000998:Antiviral Agents; D007372:Interferons