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

Regev, Arie; Berho, Mariana; Jeffers, Lennox J.; Milikowski, Clara; Molina, Enrique; Pyrsopoulos, Nikolaos; Feng, Zheng; Reddy, K. Rajender; Schiff, Eugene R.

doi:10.1111/j.1572-0241.2002.06038.x

Cited by 1,839 publications

(482 citation statements)

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“…Conflicting results have been reported in humans about the distribution of fibrosis and inflammation between lobes. Whereas some studies have reported substantial variation in fibrosis6 and inflammation12, others have shown minimal or no significant differences between lobes 13, 14, 15. However, the population in this study was not selected for clinical suspicion of liver disease, and the clinical significance of the inflammation and fibrosis in these patients unclear.…”

Section: Discussionmentioning

confidence: 83%

Histopathologic Variation between Liver Lobes in Dogs

Kemp

Zimmerman

Panciera

et al. 2015

Veterinary Internal Medicne

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BackgroundBiopsy of the liver evaluates a small portion of tissue, with inferences made to the entire organ. The method and number of biopsies obtained are tempered by consideration of the risks and benefits. Recommendations often include biopsy of more than one liver lobe, although the consistency of histopathology among lobes in dogs is unknown.Hypothesis/ObjectivesTo describe the distribution of histopathologic abnormalities between liver lobes. We hypothesized that discordant results would be evenly distributed among all liver lobes.AnimalsSeventy dogs undergoing necropsy.MethodsProspective study. Liver samples were obtained from all lobes. A primary diagnosis was assigned to each liver sample based on the predominant histopathologic abnormality.ResultsIn this population of dogs, biopsy of at least 2 liver lobes identified the predominant histologic abnormality in 98.6% of the cases. Ten (14%) of the dogs had ≤3 lobes in agreement and could not be assigned a predominant diagnosis. The same diagnosis was present in 6/6 lobes in 39 (56.5%) dogs, 5/6 lobes in 10 (14.5%) dogs, 4/6 lobes in 10 (14.5%) dogs, 3/6 lobes in 7 (10.1%) dogs, and 2/6 in 3 (4.3%) dogs. The number of discordant results did not differ between the liver lobes.Conclusion and Clinical ImportanceThe likelihood of obtaining a sample that is reflective of the predominant histologic abnormality in the liver is increased when multiple liver lobes are biopsied.

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Section: Discussionmentioning

confidence: 83%

Histopathologic Variation between Liver Lobes in Dogs

Kemp

Zimmerman

Panciera

et al. 2015

Veterinary Internal Medicne

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“…Autopsy and laparoscopy studies have demonstrated that cirrhosis is missed on a single blind liver biopsy in between 10-30% of cases. 4,5 The intra-and inter-observer variability may range from 15% to as high as 33% for determining fibrosis stage. 5 The attempts to find reliable non-invasive markers of liver fibrosis have recently increased dramatically as a result of the evolving novel therapies for hepatitis C and B.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 The intra-and inter-observer variability may range from 15% to as high as 33% for determining fibrosis stage. 5 The attempts to find reliable non-invasive markers of liver fibrosis have recently increased dramatically as a result of the evolving novel therapies for hepatitis C and B. 6,7 By analogy, a considerable interest has arisen in extending this work into the field of non-alcoholic fatty liver disease (NAFLD) because of its increased prevalence.…”

Section: Introductionmentioning

confidence: 99%

Soluble urokinase plasminogen activator receptor levels are associated with severity of fibrosis in nonalcoholic fatty liver disease

Sjöwall

Martinsson

Cardell

et al. 2015

Translational Research

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“…In addition, the limitations of needle liver biopsy with respect to sampling error and interobserver variation are well described, highlighting the need for further testing strategies. 1,2 Our deeper understanding of the mechanisms of fibrosis has led to the identification of many potential markers of fibrosis, which appear capable of identifying early and advanced hepatic fibrosis. 3,4 Standard cross-sectional imaging studies will only identify or exclude advanced fibrosis.…”

mentioning

confidence: 99%