Kam Athena, Maddison Jill E, Szladovits Balazs
Royal Veterinary College, University of London, Hatfield, UK.
J Feline Med Surg. 2025 Jun;27(6):1098612X251335202. doi: 10.1177/1098612X251335202. Epub 2025 Jun 5.
ObjectivesThis study aims to assess hepatic clinicopathological changes in cats with different hepatobiliary diseases and to assess whether specific serum biochemistry changes can help differentiate these diseases.MethodsA retrospective analysis was conducted on serum biochemistry data from 93 cats with hepatobiliary diseases and 80 control cats. Of the 93 cats with definitive diagnoses of hepatobiliary diseases, 22 had cholangitis, 14 had hepatic lipidosis, 18 had primary hepatic neoplasia confirmed via Tru-cut or laparotomic wedge biopsy and 39 had congenital portosystemic shunting (CPSS) confirmed by abdominal ultrasound. The biomarkers analysed were alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl-transferase (GGT), total bilirubin and albumin.ResultsCats with hepatobiliary disease had significantly higher enzyme activities, total bilirubin concentrations and lower albumin concentrations compared with controls ( <0.01). Comparison between diseases showed that there were no differences in hepatobiliary biomarkers between cholangitis and neoplasia, despite cholangitis being an abnormality of bile ductules and neoplasia affecting hepatic parenchymal cells. GGT activities in cats with hepatic lipidosis showed no difference compared with controls. A significant increase in ALP activity was observed in CPSS cases ( <0.01); however, this difference disappeared when the analysis was restricted to age-matched controls.Conclusions and relevanceThis study provides the most recent corroboration of previous findings on clinical pathology changes in feline hepatobiliary disease, supporting research conducted over a decade ago with new data from a different geographical location. For example, the observation that a significant increase in ALP without an increase in GGT is highly suggestive of hepatic lipidosis, aligning with findings from a 1993 study conducted in North America. In addition, this study reinforced the importance of serum biochemistry as a useful tool in differentiating cats with hepatobiliary disease from those without; however, it also reaffirmed previous conclusions that serum biochemistry alone is insufficient for a definitive diagnosis, which instead must be based on a combination of patient history, clinical signs and ancillary diagnostic tests, such as ultrasound and tissue biopsy.
目的
本研究旨在评估患有不同肝胆疾病的猫的肝脏临床病理变化,并评估特定的血清生化变化是否有助于区分这些疾病。
方法
对93只患有肝胆疾病的猫和80只对照猫的血清生化数据进行回顾性分析。在93只确诊为肝胆疾病的猫中,22只患有胆管炎,14只患有肝脂肪变性,18只经Tru-cut或剖腹楔形活检确诊为原发性肝肿瘤,39只经腹部超声确诊为先天性门体分流(CPSS)。分析的生物标志物包括丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)、总胆红素和白蛋白。
结果
与对照组相比,患有肝胆疾病的猫的酶活性、总胆红素浓度显著更高,白蛋白浓度更低(<0.01)。疾病之间的比较表明,胆管炎和肿瘤之间的肝胆生物标志物没有差异,尽管胆管炎是胆小管的异常,而肿瘤影响肝实质细胞。肝脂肪变性猫的GGT活性与对照组相比无差异。CPSS病例中观察到ALP活性显著增加(<0.01);然而,当分析仅限于年龄匹配的对照组时,这种差异消失。
结论及相关性
本研究为先前关于猫肝胆疾病临床病理变化的研究结果提供了最新的佐证,用来自不同地理位置的新数据支持了十多年前进行的研究。例如,观察到ALP显著增加而GGT没有增加高度提示肝脂肪变性,这与1993年在北美进行的一项研究结果一致。此外,本研究强化了血清生化作为区分患有肝胆疾病的猫和未患肝胆疾病的猫的有用工具的重要性;然而,它也重申了先前的结论,即仅靠血清生化不足以做出明确诊断,明确诊断必须基于患者病史、临床症状和辅助诊断测试(如超声和组织活检)的综合结果。