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CN 22-1108/R
Volume 38 Issue 7
Jul.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(7): 1590-1594

Clinical significance of ultrasound-guided percutaneous liver biopsy in the diagnosis of liver diseases

DOI: 10.3969/j.issn.1001-5256.2022.07.024

  • Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650032, China

Research funding:

National Natural Science Foundation of China (81660102);

Science and Technology Project of Science and Technology Department of Yunnan Province (2018FE001[-051]);

Postgraduate Innovation Foundation of Kunming Medical University (2021S050)

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  • Corresponding author: TANG Yingmei, tangyingmei_med@kmmu.edu.cn(ORCID: 0000-0002-0731-4198)
  • Received Date: 2021-12-06
  • Accepted Date: 2022-01-06
  • Published Date: 2022-07-20
    Abstract
  •   Objective  To investigate the disease constitution of ultrasound-guided percutaneous liver biopsy and its diagnostic efficacy in different liver diseases.  Methods  A total of 918 patients who underwent liver biopsy in Department of Pathology, The Second Affiliated Hospital of Kunming Medical University, from May 2015 to July 2020 were enrolled, and the data on pathological diagnosis and clinical diagnosis were collected. With clinical diagnosis as the criteria, the constitution ratio of liver diseases and the difference in disease constitution between sexes and ages (< 60 or ≥60 years) were analyzed, and a statistical analysis was performed for liver biopsy in the diagnosis of common liver diseases in terms of sensitivity, specificity, accuracy, positive predictive value, negative predictive value, false positive rate, and false negative rate. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups.  Results  In the 918 patients undergoing liver biopsy, the most common diseases included malignant tumor in 282 patients (30.72%), autoimmune liver disease (AILD) in 139 patients (15.14%), chronic hepatitis B (CHB) in 118 patients (12.85%), drug-induced liver injury (DILI) in 49 patients (5.34%), metabolic associated fatty liver disease (MAFLD) in 34 patients (3.70%), liver abscess in 26 patients (2.83%), benign tumor in 18 patients (1.96%), parasitic infection in 18 patients (1.96%), and alcoholic liver disease (ALD) in 9 patients (0.98%). For malignant tumor, CHB, ALD, and liver abscess, the proportion of male patients was significantly higher than that of female patients (χ2=31.67, 19.61, and 4.68, all P < 0.05), and for AILD, DILI, and parasitic infection, the proportion of female patients was significantly higher than that of male patients (χ2=58.60, 7.91, and 6.60, all P < 0.05). Compared with the patients aged ≥60 years, the patients aged < 60 years had significantly higher proportions of patients with malignant tumor, CHB, AILD, and MAFLD (χ2=105.90, 7.58, 20.03, and 6.97, all P < 0.01). The accuracy, specificity, positive predictive value, and negative predictive value of liver biopsy were all close to 100% in the diagnosis of various liver diseases, but with differences in sensitivity and false negative rate; liver biopsy had a sensitivity of 93.26%, 100%, and 94.40%, respectively, in the diagnosis of malignant tumor, benign tumor, and parasitic infection, while it had a sensitivity of 87.29%, 77.70%, and 76.60%, respectively, in the diagnosis of CHB, AILD, and DILI, with a false negative rate of 12.71%, 22.30%, and 23.40%, respectively; liver biopsy had a sensitivity of 42.31% and 44.44%, respectively, in the diagnosis of MAFLD and ALD, with a false negative rate of 57.69% and 55.56%.  Conclusion  The main disease constitution of liver biopsy includes malignant liver tumor, AILD, CHB, DILI, and MAFLD. Liver biopsy has an important diagnostic value in various types of liver diseases, with a relatively high diagnostic efficacy in malignant tumor, benign tumor, and parasitic infection, while it also has a certain false negative rate in CHB, AILD, and DILI and a fair diagnostic efficacy in MAFLD and ALD. Therefore, a comprehensive judgment should be given with reference to medical history, clinical features, and the presence or absence of other types of liver injury.

     

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