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| WHAT YOU NEED TO KNOW: LIVER BIOPSY | ||||||||||
| Liver biopsy is usually the most specific test to assess the nature and severity of liver diseases. In addition, it can be useful inmonitoring the efficacy of various treatments. There are currently several methods available for obtaining liver tissue, each with its own advantages and disadvantages. These methods will be explained in some detail later in this article. | ||||||||||
| The size of the biopsy specimen, which varies between 1 and 3 centimeters in length and between 1.2 and 2 millimeters in diameter, represents 1/50,000 of the total mass of the liver. Usually, for evaluation of diffuse liver disease (that is, disease which occurs throughout the liver, such as in hepatitis C), a specimen of 1.5 centimeters in length is adequate for a diagnosis to be made. | ||||||||||
| A liver biopsy can give valuable information regarding staging, prognosis, and management. For example, in patients with chronic hepatitis C infection, not only is there a poor correlation between symptoms or levels of serum alanine aminotransferase (ALT ? a liver enzyme which, at elevated levels, is indicative of liver-cell destruction) and histologicfeatures of the liver (that is, whether the tissue and architecture of the liver are intact or damaged), but also patients with completely normal levels of liver enzymes may be found to have clinically significant fibrosis or cirrhosis on biopsy. If the patient has mild disease and is infected with genotype 1a or 1b of the hepatitis C virus, a decision may be made to defer treatment, since these genotypes are relatively resistant to interferon. If a decision is made to treat such a patient with a combination of interferon and ribavirin and there are adverse effects, the treatment can be stopped. Conversely, if the patient has moderate-to-advanced disease, treatment will most likely be offered. If the patient has a virologic response (that is, the viral count decreases markedly) and tolerable side effects with treatment, continued therapy would be strongly encouraged. | ||||||||||
| The finding of cirrhosis on liver biopsy will determine the need for further examinations, such as upper endoscopy to rule out esophageal varices (swollen veins in the esophagus which may hemohorrage) and screening for cancer with blood tests for the presence of alpha-fetoprotein (AFP) and ultrasound of the liver. | ||||||||||
| In alcoholic liver disease, the severity of the clinical symptoms and the degree of liver-enzyme elevation correlate poorly with the extent of liver damage, particularly in patients who continue to drink alcohol. The long-term prognosis depends on the severity of hepatic, or liver, injury determined upon biopsy. Liver biopsy provides an accurate diagnosis in approximately 90 percent of patients with unexplained abnormalities revealed on liver-function tests. HOME PREV NEXT |
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| This information is provided by the Hepatitis C Support Project . a non-profit organization for HCV education, support and advocacy . � 2003 Hepatitis C Support Project . Reprint permission is granted and encouraged with credit to the Hepatitis C Support Project. | ||||||||||