title: Fibrosis assessment in chronic hepatitis C--is the liver biopsy still necessary? The pathologist point of view.
abstract: OBJECTIVE
  The aim of this study was to compare the histological stage of fibrosis determined by liver biopsy with the stage of fibrosis assessed by Fibroscan, to analyze the correspondences and inconsistencies between obtained values and to discuss the role of the microscopic exam, from the pathologist point of view.
  
  
  METHODS
  The study group consisted of 185 patients diagnosed with chronic hepatitis. Serological tests diagnosed chronic hepatitis C in 183 patients, and chronic hepatitis B and C for 2 patients. The patients were evaluated to determine the stage of fibrosis using two methods: liver biopsy and elastography (Fibroscan).
  
  
  RESULTS
  Based on the pathologic evaluation, 124 cases were diagnosed as moderate chronic hepatitis (score 6-8), and the remaining 60 cases as severe hepatitis (score 9-12). Comparison of data from examination of liver biopsy with that obtained by Fibroscan examination revealed overlapping and divergent aspects. The fibrosis stage established through liver biopsy did not always coincide with the one assigned by liver stiffness measurement, particularly for intermediate stages F2 and F3. The best overlap was noted for F0-F1 and F4 stages, which indicates the evident ability of transient elastography to separate patients with minimal or no fibrosis from patients with extensive fibrosis.
  
  
  CONCLUSIONS
  Our data concurs with the literature, which confirms presence of differences between Fibroscan and biopsy. From the point of view of the pathologist, liver biopsy still remains a valuable instrument, offering a relevant image of liver changes--as it is regarded more rather a selective than routine technique.
authors.affiliation: University of Medicine and Pharmacy Grigore T. Popa - Iaşi, Department of Morpho-Functional Science.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Moroşan
authors.forename: Maria-Sultana
authors.initials: MS
authors.lastname: Mihailovici
mesh_terms: D001706:Biopsy / Q000379:methods; D054459:Elasticity Imaging Techniques; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000473:pathology; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008111:Liver Function Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index