biopsy question?

[fretboard]

I had a bx back on 6/2005 and my stage came back as 1 to focally 2 fibrosis and there wasn't a grade listed on the report.  I remember at the time the doctor who I was seeing told me I was a grade 1.  Anyhow in October of 2008 I had another bx done and although I won't get a report b/c it was for a trial, I have seen what it says and it shows me as a stage zero and a grade 2.  

Although I am going to get the biopsy doctor's opinion as I have my last f/u appointment sometime in April.  I was wondering if this had ever happened to anyone else?  I mean where you've gotten a better biopsy than your prior one?  Any comments?

[JennyPenny]

It's my understanding that there is close to a 30% sampling error and that can account for a difference in stage in 1 out of every 3 biopsies. The grade does tend to fluctuate. Damage to the liver, at least in late stage disease, is similar throughout the entire liver.

[fretboard]

I thought of that as well, but I thought that surely they should all have a centralized area where they cut from otherwise there could be an awful lot of error.  I wonder what the percentage in error is in the world of liver biopsies?  Anyone?


fret

[Marc1955]

My understanding is that one reason biopsies can differ is that you're only looking at a small area of the liver. The grade might vary from one part of the liver to another, so that even two biopsies conducted at the same time might show slighly different results.

[fretboard]

Glad to know that it didn't only happen to me and that there are reasonable answers for why it happened.  Now I wonder if I should even try tx again.  Well I'm sure I'll come up with more questions as I regroup.  good luck to both of you

[lapis]

From my own experience, yes, biopsy results can change for the better.  I had two biopsies 17 months apart.  (why the heck would anyone do that?  It was a requirement for the study I'm in, and it just happened I'd had one over a year before that.)  Both biopsies were done at the same institution but they were read by different pathologists.

The first showed Grade 2, Stage 2.  In the time before the next bx was done, I eliminated alcohol, improved my diet, and took some herbs for liver care.  The next bx showed Gr 1, St 1-2.  The pathologist seemed surprised at the change and compared the results to my last bx, saying there was a "significant reduction" in inflammatory activity.  I'm sure that the improvement was due to my healthier lifestyle in this case.

[epiphiny]

Yes, my latest biopsy result was better than the previous biopsy I had done 4 years earlier.  My first result was G2S2, my latest was G2S1.  In between that time I had done 6 months of tx (2004) to which I was a non-responder.

I put it down to either a therapeutic response to the IFN & Riba despite never going UND, or, the different people who interpreted my biopsy came to different conclusions.  I suspect a certain amount of subjectivity comes in to such interpretations especially if the result is borderline 1/2.  You know, one person scales it up one person scales it down.