The incidence of chronic hepatitis B is extremely high in China, and patients with a long history of the disease may progress to serious conditions such as cirrhosis and liver cancer. Once significant cirrhosis occurs, it is more troublesome to treat and difficult to reverse completely. Therefore, early detection is particularly important. The early stage of cirrhosis, called fibrosis, cannot be seen on abdominal ultrasound or CT and cannot be diagnosed definitively. The diagnosis can only be made clearly by liver puncture biopsy and taking a small amount of liver tissue and placing it under a high-powered microscope. Chen Longyan, Department of Hepatology, Qilu Hospital, Shandong University Some people may ask: My liver function has been normal, is it necessary to do liver aspiration? The answer is: it is necessary. Through years of clinical observation, we have found that many patients do not have a clear history of abnormal liver function and have been in the so-called “hepatitis B carrier” state, but many years later they still developed cirrhosis. This situation can be called “occult cirrhosis”. Therefore, the concept of treatment for patients who are “hepatitis B carriers” is now more aggressive, and it is advisable to have a liver aspiration biopsy to determine whether there is liver fibrosis if possible. If there is, it can be reversed through active treatment so that it does not progress to severe cirrhosis. In addition, liver puncture biopsy can also clarify the degree of inflammation in liver tissue and the quantification of hepatitis B virus in liver tissue, which can guide the clinical use of medication. In our department, we had a patient who had a completely normal abdominal ultrasound result and a liver aspiration test showed early cirrhosis. He was actively treated with anti-cirrhosis therapy, and later the liver puncture biopsy showed very mild liver fibrosis, and his condition improved significantly. If we hadn’t done the liver puncture at the beginning and didn’t give anti-cirrhotic drugs, I’m afraid we would have had severe cirrhosis by now. The results of liver puncture mainly include the degree of inflammation (represented by G) and the degree of fibrosis (represented by S). The degree of inflammation is divided into 0~4 stages, with G0 representing no inflammation and G4 representing a heavy degree of inflammation with significant hepatocyte necrosis. The degree of fibrosis was divided into stages 0~4, with S0 representing no fibrosis and S4 representing early cirrhosis.