Specialists perform liver biopsies quite often, but usually when tests show that the liver isn't functioning properly and they don't have a reason why. When I had my liver biopsy recently, nurses informed me that for the most part people undergoing a biopsy, were doing so because their doctor wasn't sure what was wrong with them. In most cases, PBC can be diagnosed on symptoms and blood lab results, so why the need for a biopsy?
The problem with PBC is that the symptoms do not reflect the severity of the disease and this goes for the majority of the blood labs taken as well. Neither a high level of antibodies, nor the elevated enzymes can be seen as a marker for the status of the liver. The only possible way to detect how far advanced the PBC is, is to have a liver biopsy. It is also a useful way to achieve a final diagnosis.
Once the liver biopsy has been performed, the piece of liver is sent to the lab to be analyzed. In most cases the results of the biopsy are given within 5 days of surgery. Pathologists look for certain appearances to the liver and what they typically do is allot it a stage. There are four clinical stages to PBC, with the 4th stage being termed "end stage:"
Stage One: - Inflammation is present of both portal tracts and biliary ducts.
Stage Two: - Continued inflammation has caused the destruction of small bile ducts and has spread to liver cells.
Stage Three: - Fibrosis has occurred in the portal tracts and liver cells. Fibrosis is scarring.
Stage Four: - is cirrhosis.
It's important to remember that there are often stages within the stages. When someone is seen as being in "end stage," or stage 4, that final stage can last a very long time. My own biopsy showed that I was at stage 2-3, so between stages. I might stay that way for some time. Even though PBC is always progressive it isn't necessarily rapidly progressive and if medication works for you then the advance of PBC can be slowed yet further. Furthermore, if caught early, PBC sufferers in stage 1, may stay in stage 1 for years with medication, which makes an early diagnosis essential.
