Xie Xuemei, He Xiongzhi, Ye Xiangyang, Huang Xiaogang, Hu Zhenting, Zheng Fengfeng, Qiu Rongxian
Department of Infectious Disease, The Affiliated Hospital of Putian University Putian 351100, Fujian, China.
Am J Transl Res. 2024 Sep 15;16(9):4867-4875. doi: 10.62347/QQEI5676. eCollection 2024.
To explore the diagnostic value of liver biopsy in patients with acute/chronic liver diseases and to evaluate the application value of repeated liver biopsy in assessing the efficacy of antiviral therapy in patients with chronic hepatitis B.
This retrospective study involved 146 patients with acute and chronic liver diseases who underwent liver biopsy at the Affiliated Hospital of Putian University from January 2018 to December 2023. Differential diagnoses were made for patients with liver diseases based on their pathological results from liver biopsy. Additionally, the effectiveness of antiviral treatment and changes in liver fibrosis in patients with hepatitis B infection before and after antiviral therapy were assessed using repeated liver biopsy.
The overall concordance rate between clinical and histopathological diagnoses was 79.45% (116/146). Specifically, the highest concordance rate was for chronic hepatitis B at 82.61% (76/92), followed by fatty liver disease at 77.78% (7/9), autoimmune liver disease at 75% (12/16), and drug-induced liver injury at 72.72% (16/22), and lastly, hepatitis B-related cirrhosis at 71.43% (5/7). After antiviral therapy, the number of cases with positive HBeAg and HBV-DNA significantly decreased compared to before treatment, while the number of cases with negative HBeAg increased, showing a statistically significant difference (P<0.001). The number of patients at fibrosis stages S3-S4 decreased after antiviral therapy compared to before treatment (P=0.040 and P=0.028), while the number of patients at stage S2 increased (P=0.040).
Liver biopsy aids in the diagnosis of liver diseases and can effectively evaluate the degree of liver fibrosis before and after antiviral therapy for chronic hepatitis B.
探讨肝活检在急/慢性肝病患者中的诊断价值，并评估重复肝活检在评估慢性乙型肝炎患者抗病毒治疗疗效中的应用价值。
本回顾性研究纳入了2018年1月至2023年12月在莆田学院附属医院接受肝活检的146例急慢性肝病患者。根据肝活检的病理结果对肝病患者进行鉴别诊断。此外，通过重复肝活检评估乙型肝炎感染患者抗病毒治疗前后的抗病毒治疗效果及肝纤维化变化。
临床诊断与组织病理学诊断的总体符合率为79.45%（116/146）。具体而言，符合率最高的是慢性乙型肝炎，为82.61%（76/92），其次是脂肪性肝病，为77.78%（7/9），自身免疫性肝病为75%（12/16），药物性肝损伤为72.72%（16/22），最后是乙型肝炎相关肝硬化，为71.43%（5/7）。抗病毒治疗后，HBeAg和HBV-DNA阳性病例数较治疗前显著减少，而HBeAg阴性病例数增加，差异有统计学意义（P<0.001）。抗病毒治疗后，纤维化S3-S4期患者数量较治疗前减少（P=0.040和P=0.028），而S2期患者数量增加（P=0.040）。
肝活检有助于肝病的诊断，并能有效评估慢性乙型肝炎抗病毒治疗前后的肝纤维化程度。
