The Diagnostic Value of Liver Biopsy for Unexplained Liver Dysfunction: A Retrospective Study

Abstract

Ruifang Shi,1,* Fan Yang,1,* Hongli Wu,2 Yonggang Liu1 1Department of Pathology, Tianjin Institute of Hepatology, Tianjin Second People’s Hospital, Tianjin, 300192, People’s Republic of China; 2Department of Clinical Lab, Tianjin Institute of Hepatology, Tianjin Second People’s Hospital, Tianjin, 300192, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yonggang Liu, Department of Pathology, Tianjin Institute of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192, People’s Republic of China, Tel [phone], Email [email protected]: 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.Methods: 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.Results: 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.Conclusion: 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.Keywords: unexplained abnormal liver function, clinical manifestations, liver biopsy, pathology

Keywords

• unexplained abnormal liver function
• clinical manifestations
• liver biopsy
• pathology