LIVER BIOPSY: IMPORTANCE OF SPECIMEN SIZE IN THE DIAGNOSIS AND STAGING OF CHRONIC VIRAL HEPATITIS

Liver biopsy is the gold standard method for the grading and staging of chronic viral hepatitis, but optimal biopsy specimen size remains controversial. The aim of this study was to evaluate the quality of liver specimen (number of portal tracts) and to evaluate the impact of the number of portal tracts in the staging of chronic hepatitis. Material and Methods: 468 liver biopsies from consecutive patients with hepatitis C virus and hepatitis B virus infection from 2009 to 2010 were evaluated. Results: The length of fragment was less than 10 mm in 43 cases (9.3%), between 10 and 14 mm in 114 (24.3%), and ≥ 15 mm in 311 (64.4%); of these, in 39 (8.3%) cases were ≥ 20 mm. The mean representation of portal tracts was 17.6 ± 2.1 (5-40); in specimens ≥ 15 mm the mean portal tract was 13.5 ± 4.7 and in cases ≤ 15 mm was 11.4 ± 5.0 (p = 0.002). Cases with less than 11 portal tracts were associated with F3, and cases with 11 or more portal tracts with F2 (p = 0.001). Conclusion: this study demonstrated the good quality of liver biopsy and a relationship between the macroscopic size of the fragment and the number of portal tracts.

Lipoprotein oxidation: implications to atherogenesis

Lipoprotein modification is a critical step in the development of atherosclerosis. Oxidant species released by endothelial cells, smooth muscle cells, monocytes, neutrophils, macrophages and platelets can oxidatively modify lipoproteins. Oxidized lipoproteins generated in vivo may participate in the atherogenic process by different mechanisms. This review will focus on the processes leading to lipoprotein oxidation, the interactions of oxidized lipoproteins with vascular endothelium and their participation in atheroma formation, the disturbances induced by lipoprotein oxidative modifications on intravascular lipoprotein metabolism, and the occurrence of oxidative stress in subjects with hyperlipoproteinemia. The elucidation of these events may be important to establish future preventive strategies and therapeutic approaches for atherosclerosis.