Division of Gastroenterology/Hepatology, University of California, Irvine, School of Medicine, Orange, CA, USA.
Department of Pathology, University of California, Irvine, School of Medicine, Orange, CA, USA.
Dig Dis Sci. 2023 Sep;68(9):3774-3780. doi: 10.1007/s10620-023-08019-8. Epub 2023 Aug 4.
Percutaneous liver biopsy (P-bx) is the gold standard for diagnosing advanced fibrosis. Despite the proven technical feasibility of EUS-guided liver bx (EUS-bx) as a novel alternative way of liver biopsy, the clinical applicability remains to be determined.
The primary aim of this study is to evaluate if EUS-bx, compared to P-bx, can effectively and safely obtain adequate specimen and accurately predict hepatic fibrosis.
This is a single center, retrospective chart review among patients with liver diseases at a tertiary endoscopy center from February 2011 to March 2020. We assessed the EUS-bx versus P-bx outcomes by success rate, performance, and safety profile. The primary outcome was the association between EUS-bx clinical variables and the presence of histologic liver fibrosis stage ≥ 3. The secondary outcomes were the associations between EUS-bx and variables indicative of fibrosis.
Fifty-nine patients underwent EUS-bx; and 59, P-bx. All EUS-bx procedures were successfully completed. All 56/56 (100%) of EUS-bx vs. 50/52 (96.2%) P-bx were considered adequate samples. Tissue lengths were significantly longer in the EUS-bx cohort (p < 0.0001) with a trend towards a greater number of portal tracts. 46/56 (82.1%) cases of EUS-bx vs. 32/52 (61.5%) of P-bx had > 10 portal tracts; 21/56 (37.5%) cases of EUS-bx vs. 14/52 (26.9%) of P-bx had > 15 portal tracts. There were 6 (10.2%) EUS-bx vs. 1 (1.7%) P-bx related complication leading to a phone call (p = 0.061).
EUS-bx can safely performed and accurately predict liver fibrosis stage as the standard P-bx without being influenced by procedure-related factors.
经皮肝脏活检（P-bx）是诊断晚期纤维化的金标准。尽管超声内镜引导下肝脏活检（EUS-bx）作为一种新的肝脏活检替代方法具有公认的技术可行性，但临床适用性仍有待确定。
本研究的主要目的是评估 EUS-bx 与 P-bx 相比，能否有效、安全地获得足够的标本，并准确预测肝纤维化。
这是一项在 2011 年 2 月至 2020 年 3 月期间在一家三级内镜中心进行的单中心回顾性图表研究，研究对象为患有肝脏疾病的患者。我们通过成功率、表现和安全性来评估 EUS-bx 与 P-bx 的结果。主要结局是 EUS-bx 临床变量与组织学肝纤维化分期≥3 之间的关联。次要结局是 EUS-bx 与纤维化指标之间的关联。
59 例患者接受了 EUS-bx，59 例患者接受了 P-bx。所有 EUS-bx 操作均成功完成。所有 56/56（100%）的 EUS-bx 与 50/52（96.2%）的 P-bx 被认为是足够的样本。EUS-bx 组的组织长度明显更长（p<0.0001），且有更多的门脉道。EUS-bx 组 46/56（82.1%）的病例有>10 个门脉道，而 P-bx 组 32/52（61.5%）的病例有>10 个门脉道；EUS-bx 组 21/56（37.5%）的病例有>15 个门脉道，而 P-bx 组 14/52（26.9%）的病例有>15 个门脉道。EUS-bx 组有 6 例（10.2%）与 P-bx 组有 1 例（1.7%）相关并发症导致电话咨询（p=0.061）。
EUS-bx 可安全进行，并可准确预测肝纤维化分期，与标准 P-bx 一样，不受操作相关因素的影响。
