Clinical significance of liver biopsy in diagnosis of non-viral liver diseases / 中华消化杂志

ABSTRACT

Objective To observe the clinical characteristics of non-viral liver diseases which were examined by ultrasound guided liver biopsy in order to explore the significance of liver biopsy.Methods From January 2006 to December 2015,patients with non-viral liver diseases who received liver biopsy were retrospectively enrolled.Etiology,pathological diagnosis and clinical diagnosis of the patients were analyzed;the differences in disease types between male and female,among different age (less than 60 years and over 60 years)were compared;and the consistency of two pathologists in the pathological diagnosis was analyzed.Chi-square test was performed for statistical analysis.Results Among 182 patients,there were 73 (40.1％) males and 109 (59.9％) females.The most common etiology were autoimmune liver disease (68 cases,37.4％),non-alcoholic fatty liver disease (NAFLD) (40 cases,22.0％) and drug-induced liver injury (DILI) (29 cases,15.9％).The differences in etiology between male and female,between age less than 60 years and over 60 years were statistically significant (X2 =7.31 and 5.87,both P ＜ 0.05).The consistency of two pathologists in the diagnosis of NAFLD,alcoholic liver disease,hereditary metabolic disease and neoplastic disease was good (Kappa=0.85,0.88,0.75 and 1.00).The consistency rates of two pathologists in the diagnosis of autoimmune disease,NAFLD and DILI were 52.9％ (36/68),75.0％ (30/40) and 48.3％ (14/29),respectively.The consistency rate was highest in NAFLD,and the difference was statistically significant (X2 =7.68,P=0.023).However,there was no significant difference in consistency rates of two pathologists in the diagnosis of autoimmune liver disease and DILI (X2 =0.12,P=0.859).The consistency rates between pathological diagnosis and clinical diagnosis in autoimmune liver disease,NAFLD and DILI were 60.3％ (41/68),85.0％ (34/40) and 55.2％ (16/29),respectively,and the difference was statistically significant (X2 =8.98,P=0.011).The consistency rate in NAFLD was highest.However,there was no significant difference in consistency rates between pathological diagnosis and clinical diagnosis in autoimmune liver disease and DILI (X2 =0.22,P=0.639).Conclusions The liver biopsy may guide the clinical diagnosis of NAFLD.However,to improve the diagnostic rates of autoimmune liver disease and DILI,biopsy results,history and laboratory results should be combined.