ABSTRACT
The liver biopsy specimen represents valuable material for the assessment of fibrosis
and cirrhosis. Despite limitations related to sampling and interpretation, histologic
examination remains the gold standard for staging chronic liver diseases. Hepatic
fibrosis is currently viewed as a dynamic process that may often regress after successful
treatment of chronic liver diseases. Even the excess fibrous tissue of cirrhotic livers
may sometimes regress over time. Distinguishing between the amount of hepatic fibrosis
and the disease stage is important for the assessment of the effects of antifibrotic
treatments. Recent studies suggest that the proportion of the liver biopsy specimen
occupied by collagen is correlated with the hepatic venous pressure gradient in liver
transplant recipients with hepatitis C virus infection, with or without cirrhosis,
and represents a predictor of clinical decompensation. This parameter has also been
found to correlate with liver stiffness measurements of patients with chronic viral
hepatitis obtained by transient elastography. Therefore, quantitative assessment of
hepatic fibrosis in liver biopsy specimens holds promise as a prognostic marker, and
as a means to validate noninvasive markers of fibrosis.
KEYWORDS
Biopsy - cirrhosis - collagen - fibrosis - hepatitis - liver - stage
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Amar Paul DhillonM.D.
Department of Cellular Pathology, UCL Medical School
Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
eMail: a.dhillon@medsch.ucl.ac.uk
