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ISSN 2097-3497 (Online)
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)

More Information
  • 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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    • References(14)
  • [1]
    NEUBERGER J, PATEL J, CALDWELL H, et al. Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology[J]. Gut, 2020, 69(8): 1382-1403. DOI: 10.1136/gutjnl-2020-321299.
    [2]
    NAIR AV, YADAV MK, UNNI MN, et al. Hepatic amyloidosis: something that can camouflage and deceive our perception![J]. Indian J Med Paediatr Oncol, 2017, 38(2): 236-239. DOI: 10.4103/ijmpo.ijmpo_46_16.
    [3]
    GAO W, ZHONG R, ZHAO M, et al. Clinical features in the patients with hepatic amyloidosis[J/CD]. Chin J Gastrointestinal Endoscopy(Electronic Edition), 2020, 7(3): 126-129. DOI: 10.3877/cma.j.issn.2095-7157.2020.03.005.

    高文, 钟蕊, 赵曼, 等. 淀粉样变性患者临床特征分析[J/CD]. 中华胃肠内镜电子杂志, 2020, 7(3): 126-129. DOI: 10.3877/cma.j.issn.2095-7157.2020.03.005.
    [4]
    GROVER S, RASTOGI A, SINGH J, et al. Spectrum of histomorphologic findings in liver in patients with SLE: a review[J]. Hepat Res Treat, 2014, 2014: 562979. DOI: 10.1155/2014/562979.
    [5]
    KRAWCZYK M, ZIARKIEWICZ-WRÓBLEWSKA B, WRÓBLEWSKI T, et al. PEComa-a rare liver tumor[J]. J Clin Med, 2021, 10(8): 1756. DOI: 10.3390/jcm10081756.
    [6]
    WAKASUGI M, UESHIMA S, TEI M, et al. Multiple hepatic sclerosing hemangioma mimicking metastatic liver tumor successfully treated by laparoscopic surgery: Report of a case[J]. Int J Surg Case Rep, 2015, 8C: 137-140. DOI: 10.1016/j.ijscr.2015.01.032.
    [7]
    GAO G, JIANG H, ZANG GQ, et al. Analysis of 78 cases of liver biopsy with Unexplained abnormal liver function[J]. Chin Hepatol, 2017, 22(7): 608-610. DOI: 10.14000/j.cnki.issn.1008-1704.2017.07.013.

    高杲, 江红, 臧国庆, 等. 不明原因肝功能异常78例肝穿刺活检分析[J]. 肝脏, 2017, 22(7): 608-610. DOI: 10.14000/j.cnki.issn.1008-1704.2017.07.013.
    [8]
    GAO MY, ZHOU ZG, WANG M, et al. CT-guided percutaneous pulmonary biopsy for the diagnosis of ground-glass nodules: a single center study[J]. J Intervent Radiol, 2021, 30(6): 612-616. DOI: 10.3969/j.issn.1008-794X.2021.06.020.

    高梦宇, 周志刚, 王猛, 等. CT引导下经皮肺穿刺活检诊断磨玻璃结节的单中心研究[J]. 介入放射学杂志, 2021, 30(6): 612-616. DOI: 10.3969/j.issn.1008-794X.2021.06.020.
    [9]
    Chinese Society of Infectious Diseases, Chinese Medical Association, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [10]
    JI LX, YANG XX. Liver histological changes and clinical features in chronic hepatitis B with normal or mildly elevated alanine amin- otransferase[J]. J Clin Hepatol, 2020, 36(4): 778-782. DOI: 10.3969/j.issn.1001-5256.2020.04.014.

    纪林秀, 杨兴祥. ALT水平正常或轻度升高慢性乙型肝炎的肝组织学改变及临床特征分析[J]. 临床肝胆病杂志, 2020, 36(4): 778-782. DOI: 10.3969/j.issn.1001-5256.2020.04.014.
    [11]
    ÇERÇ İ O ǦLU D, KINIKLI S, CESUR S, et al. Evaluation of histological response in chronic hepatitis B patients with tenofovir or entecavir therapy[J]. Mikrobiyol Bul, 2020, 54(1): 95-109. DOI: 10.5578/mb.69122.
    [12]
    TRIVEDI PJ, HIRSCHFIELD GM. Recent advances in clinical practice: epidemiology of autoimmune liver diseases[J]. Gut, 2021, 70(10): 1989-2003. DOI: 10.1136/gutjnl-2020-322362.
    [13]
    CZAJA AJ. Behavior and significance of autoantibodies in type 1 autoimmune hepatitis[J]. J Hepatol, 1999, 30(3): 394-401. DOI: 10.1016/s0168-8278(99)80096-8.
    [14]
    CUI NN, WANG QX, MA X. An excerpt of diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the study of liver diseases[J]. J Clin Hepatol, 2020, 36(4): 758-763. DOI: 10.3969/j.issn.1001-5256.2020.04.009.

    崔娜娜, 王绮夏, 马雄. 《2019年美国肝病学会实践指引和指南: 成人和儿童自身免疫性肝炎的诊断与治疗》摘译[J]. 临床肝胆病杂志, 2020, 36(4): 758-763. DOI: 10.3969/j.issn.1001-5256.2020.04.009.
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