| Objective:To explore the grade and stage of pathology, and the relationship between grading and staging of hepatic pathohistology and noninvasive diagnostic parameters in patients with hepatitis B.Methods:256 liver biopsies of chronic hepatitis B patients (CHB) were investigated. Serum biochemical tests, including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamy (GGT), total bilirubin (TBIL), total bile acid(TBA) were detected. Platelet Parameter HBVDNA and serum levels of laminin (LN),procollagenⅢ(PCⅢ),hyalyronic acid (HA),collagenⅣ(CⅣ) were also conducted. and the results were compared with hepatitis pathological grade and stage.Results:1. Liver pathology inflammation grade and fibrosis stage was highly correlated (γ=0.821),2. The levels of TBA increased with aggravation of inflammation, and in each group were statistically significantly (P<0.01). The levels of TBIL were higher in moderate to severe chronic hepatitis B than in mild chronic hepatitis B, and the difference was statistically significant (P<0.01). The levels of AST and GGT in moderate to severe chronic hepatitis were higher than in the mild chronic hepatitis B. The levels of AST were statistically significantly between the mild chronic hepatitis B and moderate chronic hepatitis B (P <0.01), The levels of GGT were statistically significant between the mild chronic hepatitis B and moderate or severe chronic hepatitis B (P<0.01). And the levels of ALT in each group showed no statistically significantly (P> 0.05).3. The levels of PLT decreased with the increase of hepatic fibrosis stage, and in each group were statistically significantly (P<0.01), and the levels of PLT reached nearly or below the normal threshold in S4 group.The levels of MPV increased with the increase of hepatic fibrosis stage, There were no statistically significantly only in the S3 and S4 stage,while in the other stages there were statistically significant (P<0.05). The levels of PCT decreased with liver fibrosis increasing,and there were statistically significantly in between the SO stage and S2-S4 stage, S1 stage and S3-S4 stage (P<0.05). The levels of PDW in each stage showed no statistically significantly (P> 0.05).4. The levels of IVC, HA and PCⅢwere increased with the increase of hepatic fibrosis stage, but between the SO and S1 group, there was no statistically significant between the various indicators, The levels of IVC showed statistically significantly in SO or S1 and S3 (P<0.05), respectively, in the S4 and S0-S3(P <0.05).There were statistically significant between only in S0-1 and S4 for HA and PCⅢ(P<0.05).5. The levels of HBVDNA (log10) in G1 and S0-1 was significantly higher than others,and there were statistically significant between in the G1 or S0-1 and those in the G2-G4 and S2-S4,.Conclusion:1. Liver inflammatory activity and liver fibrosis stage are highly correlated.,suggesting with increase of inflammatory activity, the degree of fibrosis also increase.2. The levels of TBA increase promptly with aggravation of liver inflammation, which have the greatest significance in judging the degree of inflammation compared with other liver function index. The levels of AST, GGT, TBIL can be regarded as a reference to judge the liver inflammation, especially when the levels of TBIL were higher than normal. The levels of ALT can not be used to determine the extent of inflammatory lesions.3. With the hepatic fibrosis aggravation, the levels of PLT count and PCT decreased and the levels of MPV increased. If the levels of PLT were nearly or below the normal threshold,we should be alert to early liver cirrhosis.4. The levels of PCⅢ, HA,ⅣC may reflect the degree of liver fibrosis, It can be used to identify no or mild liver fibrosis with severe liver fibrosis. But it is of little value for identify the liver fibrosis stage. LN is less sensitive than PCⅢ,ⅣC and HA on determining the degree of liver fibrosis.5. HBVDNA has little value in judging the The severity of liver inflammatory and fibrosis activity.
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