Most patients visit hospitals to check the activity and severity of hepatitis and are used to having their blood drawn for hepatitis B triple system, liver function and liver ultrasound, but they do not understand that liver tissue specimens are collected through liver puncture and pathological examination is performed to determine the severity of liver disease. Liver biopsy is an examination method to directly observe the pathological changes of liver tissue and accurately make the diagnosis of liver disease, which is recognized as the gold standard for clinical diagnosis. Ren Hongyu, Department of Gastroenterology, Wuhan Union Medical College Hospital
The method of liver puncture biopsy is to obtain a very small amount of liver tissue from the human body through a liver puncture needle for pathological histological examination under a microscope. Is there any danger of liver puncture? The test can be done if there are no abnormalities in coagulation, as long as the appropriate laboratory tests are done before the test, such as platelet checks. In the past, the traditional liver puncture test used a thick needle, consisting of a puncture needle and a lobed core, and the puncture was performed by the cutting action of the lobed core to obtain liver tissue, which caused more damage to the liver. It is safe and reliable and does not cause any damage to the patient. So, why do patients with liver disease need to have liver puncture? What are the benefits of liver puncture for patients with liver disease?
1. To clarify the extent and activity of liver lesions
In many patients with hepatitis B virus infection, laboratory tests reveal mildly abnormal transaminases and low levels of hepatitis B virus content. A liver puncture can reveal whether these patients with chronic liver disease are in an active stage, determine the severity of their lesions, and guide the physician’s medication. If the pathology shows significant liver inflammation, antiviral therapy is administered.
2. Detection of early, quiescent or still compensated cirrhosis
Liver aspiration examination allows for an accurate diagnosis of liver fibrosis and early, quiescent or still compensated cirrhosis, and enables identification of the clinical type of cirrhosis, distinguishing between alcoholic cirrhosis, or post-hepatitis cirrhosis, with or without active hepatitis. For example, some patients diagnosed as asymptomatic virus carriers have been found to have cirrhosis or chronic active hepatitis by liver aspiration.
3. Facilitate the selection of drugs and the judgment of drug efficacy
Currently, the commonly used drugs against liver disease virus are interferon and lamivudine, etc. The application of interferon or lamivudine for antiviral treatment is not only a long course of treatment, but also expensive. If liver puncture can be performed before treatment, selective and targeted application of antiviral drugs according to the degree of inflammatory activity of liver tissue will significantly improve the efficacy.
4. Help in the differential diagnosis of various liver diseases
Many chronic liver diseases that are difficult to diagnose clinically, such as liver tuberculosis, liver granuloma, liver tumor, liver abscess, autoimmune liver disease and various metabolic liver diseases (hepatomegaly, hepatic glycogen accumulation disease, hepatic amyloidosis), require liver aspiration to understand the patient’s liver lesions and provide a decisive basis for definite diagnosis.
Ren Hongyu, Associate Professor, Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology