Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection

@article{Regev2002SamplingEA,
  title={Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection},
  author={Arie Regev and Mariana E. Berho and Lennox J. Jeffers and Clara Milikowski and Enrique G. Molina and Nikolaos T. Pyrsopoulos and Zheng Feng and K. Rajender Reddy and Eugene R Schiff},
  journal={American Journal of Gastroenterology},
  year={2002},
  volume={97},
  pages={2614-2618}
}
OBJECTIVES:Needle liver biopsy has been shown to have a high rate of sampling error in patients with diffuse parenchymal liver diseases. In these cases, the sample of liver tissue does not reflect the true degree of inflammation, fibrosis, or cirrhosis, despite an adequate sample size. The aim of this study was to determine the rate and extent of sampling error in patients with chronic hepatitis C virus infection, and to assess the intraobserver variation with the commonly used scoring system… 

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References

SHOWING 1-10 OF 36 REFERENCES

Liver biopsy in chronic aggressive hepatitis. Diagnostic reproducibility in relation to size of specimen.

The predictive value of a diagnosis present (diagnostic specificity) and a diagnosis absent ( Diagnostic sensitivity) was used in evaluating the efficiency of the diagnosis made on the visible part of the biopsy.

Intra-observer and inter-observer variation in the histopathological assessment of chronic viral hepatitis.

A blinded trial in which 20 cases of chronic viral hepatitis were assessed by five histopathologists, using the Knodell and Scheuer scoring systems, concluded that, while both systems produced reasonable agreement, this was greater using the Scheuer system.

The role of laparoscopy in the diagnosis of cirrhosis.

Reproducibility of liver biopsy diagnosis in relation to the size of the specimen.

The microscopic diagnosis of AVH was found to be safe even on biopsies only 5 mm long, and the predictive value of both presence and absence of lesion absent was used in evaluating the efficiency of the diagnoses of the individual lesions.

Sampling variability on percutaneous liver biopsy.

Sampling variability of liver biopsy was determined in three consecutive biopsy specimens obtained from each of 118 patients immediately prior to autopsy. No sampling variability was found for fatty

Hepatitis C virus RNA quantification in right and left lobes of the liver in patients with chronic hepatitis C

The results indicate that hepatitis C virus RNA quantification from a single liver biopsy is representative of both lobes in patients with chronic hepatitis, and suggest that serum hepatitisC virus RNA levels are a meaningful reflection of hepatitis Cirus RNA levels in the liver.

Grading and staging the histopathological lesions of chronic hepatitis: The Knodell histology activity index and beyond

The current practice for reporting histopathological evaluation of chronic hepatitis involves separate statements for the cause of disease, if known, for severity of necroinflammatory lesions, and for the extent of parenchymal fibrosis.

Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis

A Histology Activity Index has been developed which generates a numerical score for liver biopsy specimens obtained from patients with asymptomatic chronic active hepatitis that provides definitive endpoints for statistical analysis of serial changes in liver histology and offers an alternative to the use of conventional pathological descriptions.

Chronic hepatitis. An update on terminology and reporting.

For the reporting practice of pathologists, it is recommended that the pathologist routinely sign out biopsy samples with features of chronic hepatitis by indicating etiology, grade, and stage, which eliminates ambiguous terminology and avoids the risk of inappropriate treatment.