虽然肝脏活检标本破碎可能提示
肝硬化，但在已发表的文献中仍难找到相关依据。为此，美国阿肯色州医科大学的A. H. Malik博士及其同事对经皮肝活检标本的破碎是否与纤维化程度相关进行了研究。
186例患者前瞻性进行经皮肝脏活检，并检测标本的碎片长度和数量。病理医生在不知晓
临床资料的情况下，对纤维化程度进行评分。比较不同分期的碎片长度和破碎资料。
结果显示，全部碎片的平均长度为1.85cm，平均碎片数目为4个。晚期纤维化（Ⅲ～Ⅳ期）标本的碎片数目多于无或轻度纤维化（0～Ⅱ期）标本（P<0.0001）。随着纤维化分期的增加，总碎片长度降低（P<0.0001）。仅有晚期纤维化标本的碎片数目多于12个。
Malik博士等认为，经皮肝活检标本经常出现破碎，碎片随纤维化由早期至晚期的进展而增多。纤维化标本的碎片更常见，并且更广泛。
Aliment Pharmacol Ther. 2004 Mar;19(5):545-9.
Correlation of percutaneous liver biopsy fragmentation with the degree of fibrosis.
Malik AH, Kumar KS, Malet PF, Jain R, Prasad P, Ostapowicz G.
Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.
BACKGROUND: : Although fragmentation of a liver biopsy specimen has been considered to be suggestive of cirrhosis, the evidence for this is difficult to find in the published literature. AIM: : To determine whether fragmentation of percutaneous liver biopsy specimens correlates with the degree of fibrosis. METHODS: : One hundred and eighty-six patients underwent percutaneous liver biopsy prospectively. The specimens were measured for the length and number of fragments. The extent of fibrosis was scored by a pathologist blind to the clinical data. Length and fragmentation data were compared between the different stages. RESULTS: : The overall median fragment length was 1.85 cm and the median fragment number was four. Specimens with advanced fibrosis (stages III-IV) had more fragments than those with no or mild fibrosis (stages 0-II) (P < 0.0001). The aggregate fragment length decreased with increasing stage of fibrosis (P < 0.0001). Specimens with greater than 12 fragments were seen only with advanced fibrosis. CONCLUSIONS: : Fragmentation of percutaneous liver biopsy specimens is common and increases with progression from early to advanced fibrosis. Fibrotic specimens fragment more often and more extensively.
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自动采集 2005-2-23