A systematic review of the quality of liver biopsy specimens.
Characteristics for an optimal liver biopsy specimen were recently defined as 20 to 25 mm long and/or containing more than 11 complete portal tracts (CPTs). A systematic review of percutaneous liver biopsy (PLB) and transjugular liver biopsy (TJLB) series yielded only 32 PLB studies in which these characteristics were evaluated: mean +/- SD length, 17.7 +/- 5.8 mm and number of CPTs, 7.5 +/- 3.4; and 15 TJLB studies: mean +/- SD length, 13.5 +/- 4.5 mm and number of CPTs, 6.8 +/- 2.3. Studies of sampling heterogeneity and intraobserver and interobserver variability also used inadequate specimens by present standards. Only 11 (5.3%) of 207 therapeutic studies for chronic hepatitis B and C documented length and/or number of CPTs. Of the current 12 studies evaluating noninvasive fibrosis tests, only 8 documented length or number of CPTs, and only 1 documented length and number of CPTs. New studies are needed based on adequate liver biopsy samples to provide reliable estimation of grading and staging in chronic liver disease.
Cholongitas
Evangelos
E
Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, Pond Street, Hampstead, London, England.
Senzolo
Marco
M
Standish
Richard
R
Marelli
Laura
L
Quaglia
Alberto
A
Patch
David
D
Dhillon
Amar P
AP
Burroughs
Andrew Kenneth
AK
D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000473:pathology*; D015588:Observer Variation; D011168:Portal System / Q000473:pathology; D011786:Quality Control; D013048:Specimen Handling