ORIGINAL: The Pre-Fibroscan and Fibroscan Era: A Comparative Study of Histologic Diagnosis of Liver Biopsies

West Afr J Med. 2024 August; 41(8): 874-878 PMID: 39737480

Authors

  • I. Emmanuel
  • C. Amaike Department of Community Medicine, Babcock University and Babcock University Teaching Hospital, Illishan Remo, Ogun State, Nigeria.
  • P. O. Akpa
  • B. V. Kwaghe Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • C. N. Ibeanu Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • P. Onota Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • I. A. Othman Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • N. Z. Bahaushe Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • J. E. Ben Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • J. A. Emmanuel Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • S. J. Winnie Department of Nursing Science, Babcock University and Babcock University Teaching Hospital, Illishan Remo, Ogun State, Nigeria.
  • T. Leslie Department of Nursing Science, Babcock University and Babcock University Teaching Hospital, Illishan Remo, Ogun State, Nigeria.
  • T. N. Fadok Department of Histopathology, Federal Medical Center Jalingo, Taraba State, Nigeria.
  • P. M. Davwar Department of Medicine, Jos University Teaching Hospital, Nigeria.
  • A. S. Dahal Department of Medical Microbiology, Jos University Teaching Hospital, Nigeria.
  • Y. D. Maktep Department of Medical Microbiology, Jos University Teaching Hospital, Nigeria.
  • B. K. Adedeji Department of Histopathology, Federal University of Health Science Teaching Hospital Otukpo.
  • A. S. Longwap Department of Chemical Pathology, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • A. I. Bawa Department of Chemical Pathology, Abubakar Tafawa Balewa University Teaching Hospital, Nigeria, Bauchi, Bauchi State, Nigeria.
  • B. M. Mandong Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.
  • D. E. Suleiman Department of Histopathology, Abubakar Tafawa Balewa University, Bauchi.

Keywords:

Biopsy, Fibroscan, Gastroenterologist, Liver, Surgeon

Abstract

Background: The advancement in non-invasive methods for diagnosing and characterizing liver disease has achieved significant success. One such methods, FibroScan, combines non-invasiveness, rapidity, painlessness, and reproducibility. However, its accuracy and value are limited in many clinical settings. The liver biopsy, the gold standard for assessing liver fibrosis offers direct visualization and provides extensive information through histology and ancillary investigations a noticeable gap of Fibroscan and other non-invasive methods.

Aim and objective: To determine the rate of histology requests by gastroenterologists and surgeons at the Jos University Teaching Hospital during the pre-FibroScan era and the FibroScan era in the Jos metropolis.

Methodology: Patient biodemographic information and histologic diagnoses, along with the category of the requesting physician (gastroenterologist or surgeon) for liver biopsies, were extracted from hospital records. Data were collated for the pre-FibroScan era (2004-2010) and the FibroScan era (2011-2023), spanning 20 years. All patients with liver biopsies submitted for histologic analyses were included while those with inadequate biodemographic data, histologic diagnoses, and category of requesting physician were excluded.

Results: Two hundred and eighteen (218) liver biopsies were received during the study of the period. Of these, two hundred and eight (95.4%) met the study criteria, with 111 (53.4%) from the pre-FibroScan era and 97 (46.6%) from the FibroScan era. In the pre-Fibroscan era,110(99.09%) 1(0.01%) histology requested were by gastroenterologist and surgeons respectively, while in the Fibroscan era the respective requests by these specialties were 36(37.11%) and 97(62.89%). The first year of the Fibroscan era (2011) accounted for 22(61.11%) of the 36(100.00%) cases liver biopsies requested by gastroenterologist, with a corresponding value of 11(16.67%) of 66(100.00%) for surgeons. The significance concerning the requesting physician's specialty with p-value of 0.003.

Conclusion: For the foreseeable future, the FibroScan cannot replace the value of direct tissue histological assessment, especially where molecular studies and other ancillary investigations are crucial for targeted therapy and research. Histology remains the gold standard for the aforementioned reasons and probably will until the non-invasive investigations can provide the myriads of valuable information it avails.

Author Biographies

I. Emmanuel

Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.

Department of Pathology, University of Jos, Jos, Plateau State, Nigeria.

P. O. Akpa

Department of Anatomic Pathology and Forensic Medicine, Jos University Teaching Hospital, Nigeria, Jos, Plateau State, Nigeria.

Department of Pathology, University of Jos, Jos, Plateau State, Nigeria.

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Published

2024-08-30