Abstract
Background and aim
Liver biopsy is the gold standard for assessment of fibrosis in patients with hepatitis B. However, it has some disadvantages, including inter-observer and intra-observer variability in biopsy interpretation and specimen variation. A standard biopsy specimen represents only about 0.0002 % of the whole liver. It has been shown that two biopsy samples collected during a procedure have significant influence on the diagnostic performance of interpretation in patients with hepatitis C or non-alcoholic steatohepatitis. Therefore, we aimed to assess the influence of collecting two liver biopsy samples during a single procedure for staging and grading chronic hepatitis B.
Patients and methods
27 patients were included in the study. The median age of the patients was 43.51 ± 11.69. Fifteen patients were female, 12 patients were male. In the biopsy procedure, two samples of liver lobes were obtained. Grade and stage scores were compared between the two samples. Fibrosis staging and grading were assessed according to the Ishak scoring system.
Results
Numbers of portal tract and biopsy size were equal in the two samples. There was a significant difference between the samples in terms of histological activity index (p value = 0.04). However, the difference was not enough to distinguish the mild and moderate stages. On the other hand, no significant difference in fibrosis staging between the two samples was found.
Conclusions
With this relatively small size of patients, in this study, we showed that a proper liver biopsy size is sufficient to predict treatment decisions in chronic hepatitis B patients. However, further studies are needed to show the association of sampling variability in patients with hepatitis B.
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Fuat Ekiz, İlhami Yuksel, Ata Turker Arikök, Baris Yilmaz, Akif Altinbas, Bora Aktas, Murat Deveci, Omer Basar, Sahin Coban, Osman Yuksel declare that they have no conflicts of interest.
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Our study was performed according to the guidelines of the Declaration of Helsinki, and the ethics review committee of our hospital approved it.
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Informed consent to participate in the study was received from all patients.
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Ekiz, F., Yuksel, İ., Arikök, A.T. et al. Will a second biopsy sample affect treatment decisions in patients with chronic hepatitis B?. Hepatol Int 10, 602–605 (2016). https://doi.org/10.1007/s12072-015-9666-5
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DOI: https://doi.org/10.1007/s12072-015-9666-5