Future Aspects of Liver Biopsy: From Reality to Mathematical Basis of Virtual Microscopy

Tissue investigation remains one of the most reliable diagnostic ways in both general medical practice and liver pathology. At present, the routine liver biopsy investigation should include obtaining a representative tissue sample, adequate technological processing and application of histochemical stain panel [1-5]. The evaluation must be done in accordance with up-to-date disease classifications and validated diagnostic criteria [6]. Protocol approach is recommend‐ ed in order to decrease the variability in description. In case of chronic inflammatory liver dis‐ ease, semiquantitative evaluation of inflammatory activity by Knodell, Ishak, METAVIR or Scheuer score, or analogous system [7-11] must be applied. Additional methods as immuno‐ histochemistry or polymerase chain reaction are applied by necessity. The morphological evaluation of biopsy is a part of medical teamwork. It should be preceded by clinical and lab‐ oratory investigations and biopsy findings must be incorporated in the general patient’s in‐ formation. Many of these principles will remain in use in the nearest future. However, both clinical diagnostics and medical research undergo almost unlimited progress. The upcoming innovations in liver biopsy analysis include incorporation of digital image analysis, genetic investigations and immunohistochemistry for functionally important molecules as cytokines, cell cycle markers and viral life cycle markers into everyday practice.