Pathological,epidemiological and prognostic studies in 25946 patients with liver disease with liver needle biopsy / 解放军医学杂志

ABSTRACT

Objective To study the disease spectrum,the features of clinical pathology,epidemiology and prognosis of liver diseases in Chinese populations from Jan.1980 to Jun.2008.Methods Twenty-five thousand nine hundred and forty-six patients with liver diseases in a wide spectrum of inhabitants(including 1 448 military patients) from 31 provinces or cities of all over mainland China in recent 28 years were involved in the present study for a retrospective study regarding their clinical,pathological and epidemiological features,including laboratory re-examinations and pathological examination.1 322 patients with liver disease(course lasted from 6 months to 18 years) were followed-up by more than 2 liver biopsies to study the outcome of chronic hepatitis B.Results For all the patients involved,the sex ratio of male to female was 3 to 1,with mean age of 32.3?14.4 years ranging from 41 days to 91 years,and the diseases occurred predominantly between the age of 18 to 37 years.Hebei,Henan,Beijing,Shandong and Shanxi provinces(city) ranked at the fore in the endemic distribution of the diseases.The spectrum of liver disease covered more than 100 kinds of liver diseases,of which 73.05% were infectious liver disease.As a whole,the incidence of both infectious and non-infectious,especially the non-infectious liver diseases became more prevalent since 2000.It was shown that the chronic hepatitis B was the most predominant factor which caused liver failure,liver cirrhosis and liver cancer,and chronic hepatitis C was the second factor.Chronic infection pathological changes were found in the liver tissues in 0.26% patients with hepatitis A and 0.51% patients with hepatitis E.For all the 1 322 followed-up patients with chronic hepatitis B,the incidence of liver cirrhosis and hepatocellular carcinoma was respectively 15.36%(203 cases) and 1.06%(14 cases),and the average progressive period for the changes in pathology was 46.37?16.93 months and 60.29?39.15 months,respectively.Meanwhile,the degree of liver fibrosis increased more than one stage in 188 patients(14.22%),decreased more than one stage in 441 patients(33.36%),and no change in 476 patients(30.01%).Conclusions The liver disease spectrum during recent 28 years in Chinese populations has been essentially identified by a retrospective analysis of a large number of clinical pathological data.The clinical features of predominant liver diseases have been illustrated,and the outcome and transition time of chronic hepatitis B has been elucidated in present study.