Clinical-liver, pancreas, and biliary tractSampling Variability of Liver Biopsy in Nonalcoholic Fatty Liver Disease
Section snippets
Selection Criteria
Consecutive patients with a suspected diagnosis of NAFLD were prospectively enrolled in this study. The diagnosis of NAFLD was based on the following: (1) a bright pattern of the liver on abdominal ultrasound, (2) elevated serum transaminase levels, and (3) no other identifiable causes of liver disease. Other causes of liver disease were ruled out by appropriate work-up: these included daily alcohol consumption greater than 30 g for men and 20 g for women; drug-induced hepatotoxicity; infection
General Description
A total of 51 patients was included in this study: 31 men and 20 women. Their mean age was 54.9 years (range, 31–73 years). Median body mass index was 31.6 kg/m2 (range, 21.6–44.6). All patients had compensated liver disease, and abnormal liver function tests were discovered either fortuitously (24%) or during a work-up for dyslipidemia (43%) or diabetes and dyslipidemia (33%).
Characteristics of the biopsy samples and the main histologic results are given in Table 2. The difference in size
Discussion
This study shows that most NAFLD-related pathologic features display considerable sampling variability when collected through percutaneous liver biopsy. Agreement between the 2 biopsy specimens was only moderate for most features, including hepatocyte ballooning and perisinusoidal fibrosis, whereas, for some others, such as acidophilic bodies, lobular inflammation, or Mallory bodies, the agreement was poor. Only steatosis grade and interface hepatitis displayed substantial agreement between the
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V.R. and F.C. contributed equally to the study.
Members of the LIDO (Liver Injury in Diabetes and Obesity) Study Group are: André Grimaldi, Philippe Giral, Eric Bruckert, Gérard Turpin, Agnès Heurtier, Sophie Gombert, Francine Lamaison, Joseph Moussalli, Sophie Le Calvez, Yves Benhamou, Cecilia D’Arrondel, Arnaud Cocaul, Isabelle Ravalet, Stéphanie Combet, Hôpital Pitié Salpêtrière; Philippe Podevin, Hôpital Cochin; Arnaud Basdevant, Gérard Slama, Karine Clement, Hôpital Hotel-Dieu; Lawrence Serfaty, Chantal Housset, Jacqueline Capeau, Hôpital Saint Antoine.