HBsAg 양성 간질환 환자의 간 우엽 및 좌엽의 조직학적 소견의 비교

Abstract

We compared the histological diagnosis and activity between the right and left lobes in order to assess the sampling variability in HBsAg(+) chronic liver diseases. From May 1987 to September 1991, we prospectively evaluated 23 patients(male 19, female 4, mean age; 32.0±8.8) with HBsAg(+) chronic liver diseases. Peritoneoscopic liver biopsies of the right and left lobes were performed using Vim Silverman needle. Peritoneoscopic diagnosis and histologic diagnosis were compared and histologic diagnosis of the right and left lobes were compared. Also, histological activities of the right and left lobes were compared using numerical scoring system. Results were as follows; 1) Peritoneoscopic gross findings in both lobes were different in 10 patients (43.5%). Of these 10 patients, 7 patients showed more severe findings in the left lobe. 2) In comparison with histologic diagnosis, peritoneoscopic diagnosis were correct in 56.5% in the right lobe, and in 60.0% in the left lobe. 3) Histologic diagnosis between the right and left lobes were different in 8 patients(34.8%). Among these, 4 patients revealed more severe findings in the right lobe, and 4 patients in the left lobe. 4) Of 10 patients with different peritoneoscopic gross findings, 5 patients revealed different histologic diagnosis. Different histologic diagnosis in spite of the same peritoneoscopic gross findings was noted in 3 patients. 5) The scores of each category and total score were almost the same between lobes. However, 13 of the 23 patients(56.5%) showed l point or more of the score difference between the right and left lobes. Among these patients, 6 patients showed 2 points or more of the score difference. According to the results obtained, we concluded that simultaneous biopsies on both lobes of the liver are necessay in order to minimize sampling variability, even in patients undergoing peritoneoscopy.