Shi Ruifang, Yang Fan, Wu Hongli, Liu Yonggang
Department of Pathology, Tianjin Institute of Hepatology, Tianjin Second People's Hospital, Tianjin, 300192, People's Republic of China.
Department of Clinical Lab, Tianjin Institute of Hepatology, Tianjin Second People's Hospital, Tianjin, 300192, People's Republic of China.
J Multidiscip Healthc. 2024 May 17;17:2399-2407. doi: 10.2147/JMDH.S460338. eCollection 2024.
To analyse clinical manifestations of unexplained abnormal liver function and perform hepatobiliary histopathology procedures on patients to evaluate the value of liver biopsy in diagnosing the aetiology of unexplained abnormal liver function.
A convenience sampling method was used to retrospectively collect the data of patients who were diagnosed with unexplained abnormal liver function and who received liver biopsy in the Pathology Department of Tianjin Second People's Hospital, China, between March 2022 and July 2023 to analyse liver pathology and clinical manifestations.
A total of 1302 patients were included in this study, which mainly included 11 diseases: autoimmune liver disease (74 cases, 5.68%), drug-induced liver injury (DILI) (204 cases, 15.67%), cancer (237 cases, 18.20%), non-alcoholic fatty liver disease (104 cases, 7.99%), non-alcoholic steatohepatitis (74 cases, 5.68%), viral hepatitis (490 cases, 37.63%), other types of hepatitis (30 cases, 2.30%), cholestatic liver disease (17 cases, 1.31%), alcoholic liver disease (15 cases, 1.15%), hepatic cyst (5 cases, 0.38%) and Gilbert syndrome (4 cases, 0.31%). The success rate of liver biopsy sampling was 100%, and (1.52 ± 0.130) tissue strips were sampled. The average operating time was 11.52 minutes. The percutaneous liver biopsy did not significantly increase short-term liver function index values (serum γ-glutamyl transpeptidase, total bilirubin, alanine transaminase, aspartate aminotransferase, alkaline phosphatase). Ninety-two patients had a small amount of liver subcapsular fluid, but there was no progress after medical treatment.
Ultrasound-guided percutaneous liver biopsy has value in the diagnosis of unexplained abnormal liver function. Viral hepatitis, cancer and DILI are the most common causes of unexplained abnormal liver function. Liver biopsy does not aggravate the organic and functional impairment of the liver.
分析不明原因肝功能异常的临床表现，并对患者进行肝胆组织病理学检查，以评估肝活检在诊断不明原因肝功能异常病因中的价值。
采用便利抽样法，回顾性收集2022年3月至2023年7月在中国天津市第二人民医院病理科诊断为不明原因肝功能异常并接受肝活检的患者资料，分析肝脏病理及临床表现。
本研究共纳入1302例患者，主要包括11种疾病：自身免疫性肝病（74例，5.68%）、药物性肝损伤（DILI）（204例，15.67%）、癌症（237例，18.20%）、非酒精性脂肪性肝病（104例，7.99%）、非酒精性脂肪性肝炎（74例，5.68%）、病毒性肝炎（490例，37.63%）、其他类型肝炎（30例，2.30%）、胆汁淤积性肝病（17例，1.31%）、酒精性肝病（15例，1.15%）、肝囊肿（5例，0.38%）和吉尔伯特综合征（4例，0.31%）。肝活检取材成功率为100%，取材组织条为（1.52±0.130）条。平均手术时间为11.52分钟。经皮肝活检未显著增加短期肝功能指标值（血清γ-谷氨酰转肽酶、总胆红素、丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶）。92例患者有少量肝包膜下积液，但经治疗后无进展。
超声引导下经皮肝活检对不明原因肝功能异常的诊断有价值。病毒性肝炎、癌症和DILI是不明原因肝功能异常最常见的病因。肝活检不会加重肝脏的器质性和功能性损害。
