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Biopsy Variability Affects Diagnosis of Liver Disease

Last Updated: April 23, 2009.

The number of liver biopsies analyzed, biopsy length, and number of independent biopsy readings affects the variability of histologic findings and diagnosis of nonalcoholic steatohepatitis (NASH) in patients with suspected nonalcoholic fatty liver disease (NAFLD), according to a study in the April issue of Clinical Gastroenterology and Hepatology.

THURSDAY, April 23 (HealthDay News) -- The number of liver biopsies analyzed, biopsy length, and number of independent biopsy readings affects the variability of histologic findings and diagnosis of nonalcoholic steatohepatitis (NASH) in patients with suspected nonalcoholic fatty liver disease (NAFLD), according to a study in the April issue of Clinical Gastroenterology and Hepatology.

Raj Vuppalanchi, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues collected three cores of liver tissue by percutaneous liver biopsy from 50 patients suspected of having NAFLD.

The researchers found that steatosis, lobular inflammation, and fibrosis scores, but not ballooning or the presence of definite NASH, were significantly higher when analyzing three cores compared with two cores. Longer biopsy samples were associated with greater percentages of patients with definite NASH (65 percent for biopsies 25 millimeters or longer compared with 29 percent for biopsies less than 10 millimeters long). Compared with a single reading, a composite of two independent readings by the same pathologist was associated with a higher percentage of patients with definite NASH, which was significant when analyzing three samples (from 61 to 67 percent).

"There is a significant relationship between histological yield and sample length and number of independent readings of liver biopsy samples," Vuppalanchi and colleagues conclude.

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