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    31 August 2023, Volume 28 Issue 8
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    Liver Fibrosis & Cirrhosis
    Risk factors and prevention of rebleeding in patients with liver cirrhosis complicated with esophageal and gastric varices bleeding
    WU Ting, TANG Qi-yuan, LIAO Xue-jiao, LAI Chang-xiang, HE Qing
    2023, 28(8):  903-906. 
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    Objective To investigate the risk factors and prevention as well as treatment of rebleeding in patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding (EGVB) in Shenzhen.Methods The clinical data of 548 cases with liver cirrhosis complicated with esophageal and gastric varices in Shenzhen were collected and divided into bleeding group and non-bleeding group according to whether there was bleeding. The age, sex, cause of liver cirrhosis and results of auxiliary examinations (including platelet count, liver function, coagulation function, spleen diameter and ascites, etc.) of the two groups were retrospectively analyzed and compared. The related risk factors of EGVB and the prevention and treatment of rebleeding were investigated.Results The results of univariate analysis showed that there were significant differences in 9 factors, including the cause of liver cirrhosis, Child-Pugh grade, ascites, hepatic encephalopathy and platelet count between the two groups (all P<0.05). Multivariate logistic regression analysis showed that platelet count and albumin were negatively correlated with EGVB (OR value is between 0~1), and ascites was positively correlated with EGVB (OR value is 3.068). In the bleeding group, 109 cases (about 51.4%) received prophylactic treatment for rebleeding, including 90 cases of endoscopic therapy, 2 cases of surgical therapy, 1 case of interventional therapy and liver transplantation, and 15 cases of combined therapy.Conclusion Patients with esophageal and gastric varices who with ascites in Shenzhen may be more prone to variceal bleeding, which should be paid attention to in clinical practice. At the same time, attention should be paid to clinical protective measures, and if necessary, normative secondary prevention and treatment should be feasible.
    Clinical utility of color Doppler flow spectrum of hepatic vein for liver fibrosis staging
    CHEN Yong-liang, ZHAO Hui, WANG Xiao-jing, LI Qiu-yu, PAN Li, LI Zhen-yan
    2023, 28(8):  907-911. 
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    Objective To investigate the value of color Doppler flow spectrum of left, middle and right hepatic veins in staging liver fibrosis.Methods In this study, Color Doppler ultrasound was used to record the spectral waveforms of the left, middle, and right hepatic veins in 344 patients with chronic hepatitis. All patients were subjected to a pathological liver biopsy for diagnosis, and the spectral waveforms obtained from the hepatic veins were subsequently compared with the liver fibrosis staging.Results The 344 patients with spectral waveforms of the hepatic vein were divided into three types: bi-direction wave(type O), uni-direction wave( type I), and continuous flat wave (type II). According to the degree of liver fibrosis, patients were also grouped into mild (S0~S1), moderate (S2~S3) and severe (S4) categories. The composition ratio of the left, middle and right hepatic veins exhibiting Type O, Ⅰ and Ⅱ waves, across the mild, moderate, and severe groups, showed significant differences with χ2=30.090, 29.447, 15.572, P<0.001. The correlation between the liver fibrosis stage and type O and type Ⅱ waves of the left hepatic vein was statistical significance(r=-0.268, 0.194, P<0.001). The correlation between the liver fibrosis stage and type O, type Ⅰ and type Ⅱ waves of the middle hepatic vein was also significant(r=-0.268, 0.108, 0.154, P<0.001, <0.05, <0.05). Moreover, the correlation between the liver fibrosis stage and, type O and type Ⅱ waves of the right hepatic vein was significant(r=-0.198, 0.147, P<0.001, <0.05).Conclusion The color Doppler blood flow spectrum from three hepatic veins-left , middle and right-proved a comprehensive reflection of the liver fibrosis degree. Moreover, the spectral readings from the middle hepatic vein appears to be more reliable than those from the left and right hepatic veins when used as an evaluation index.
    Efficacy of endoscopic titanium clip combined with cyanoacrylate injection in the treatment of gastric varices
    XI Liang, QUAN Xing-pu, WANG Xiao-wei, WANG Yun, QIU He, XU Jun-wang
    2023, 28(8):  912-915. 
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    Objective To investigate the clinical efficacy of endoscopic metal titanium clip combined with cyanoacrylate injection on GOV1, GOV2, IGV1 gastric varices.Methods Retrospective analysis of 150 patients with gastric varices of GOV1, GOV2 and IGV1 who were hospitalized in the First Affiliated Hospital of Xi'an Jiaotong University from January 1, 2017 to December 31, 2020. According to the treatment plan, it was divided into a control group (cyanoacrylate treatment, 105 cases) and an observation group (titanium clip combined cyanoacrylate treatment, 45 cases). The clinical efficacy, rebleed rate and complications of the two groups were compared and analyzed. Follow-up treatment was performed at 0, 1, 3, and 6 months, for a total of 10 months.Results The gastric / splenorenal shunt rate in the observation group was 22.2%, which was significantly higher than 0% in the control group (0%) (P<0.001); the number of gastric varices in the observation group was 3 (3, 3), which was significantly higher than 3 (2, 3) in the control group (P=0.028); the average cyanoacrylate dosage in the observation group was 3.29±1.0 mL, which was significantly lower than 4.11±1.51 mL in the control group (P=0.020); the rebleeding rate in the observation group was 11.1%, significantly lower than 27.6% in the control group(P=0.027). There was no significant difference between the two groups in the number of endoscopic treatment, injection points of cyanoacrylate, effective rate, varicose eradication / basic disappearance rate, postoperative sternal pain and fever (P>0.05). No serious complications such as bacteremia and ectopic embolism occurred in the two groups.Conclusion Titanium clip combined with cyanoacrylate injection therapy can reduce the amount of tissue glue, reduce the incidence of postoperative rebleeding, and may block the occurrence of ectopic embolism in gastric/spleen-kidney shunts. It is an effective treatment for gastric varices of GOV1, GOV2 and IGV1.
    Construction and validation of the risk prediction model for secondary hepatic encephalopathy in patients with chronic hepatitis B and cirrhosis
    ZHANG Jia-qi, WANG Zai-chao, YANG Jia-yao, WANG Xiao-meng, ZHAO Yu
    2023, 28(8):  916-920. 
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    Objective To investigate the risk factors of secondary hepatic encephalopathy (HE) in patients with chronic hepatitis B (CHB) and cirrhosis, construct a risk prediction model, and verify it.Methods A total of 202 patients with CHB and cirrhosis admitted to the hospital from January 2021 to June 2022 were retrospectively analyzed. According to the presence or absence of secondary HE, the patients were divided into HE group (59 cases) and non-HE group (143 cases). Clinical data of the patients were collected. The risk factors were screened by logistic regression analysis, and a prediction model was constructed. The ROC curve was used to verify the predictive performance of this model.Results Logistic regression analysis results showed that transjugular intrahepatic portosystemic stent-shunts (TIPS, OR=3.043), upper gastrointestinal bleeding (OR=4.007), electrolyte acid-base balance disorder (OR=2.401), hepatorenal syndrome (OR=4.540) and constipation (OR=2.838) were risk factors of secondary HE (P<0.05). The risk prediction model was as follow: P=ex/(1+ex), X=-2.375+1.113×TIPS+1.388×upper gastrointestinal bleeding+0.876×electrolyte acid-base balance disorder+1.513× hepatorenal syndrome+1.043×constipation. The area under the ROC curve (AUC), sensitivity, specificity and Youden index were 0.841 (95%CI=0.772, P<0.001), 80.36%, 80.00% and 0.604, respectively.Conclusion The prediction model can help to better predict the occurrence of HE in patients with CHB and cirrhosis. Clinically, the model can be used to evaluate patients with CHB and cirrhosis, thereby assisting in targeted measures to prevent the occurrence of HE.
    Liver Cancer
    A prognostic analysis on the radical resection of primary hepatocellular carcinoma with microvascular invasion by different resection margin schemes
    NIE Bin, ZHAO Tie-jun, ZHANG Sheng-long
    2023, 28(8):  921-923. 
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    Objective To perform the prognostic analyses and comparison of primary hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) treated by different resection margin schemes.Methods A total of 145 HCC patients who underwent radical hepatectomy from January 2016 to April 2022 in Chengdu BOE Hospital were collected, including 88 males and 57 females, with an average age of (52.7±7.8) years. According to the width of surgical margin, the patients were divided into a <1 cm group (Group A, n=99 cases) and a >1 cm group (Group B, n=46 cases). Both groups of patients were followed up for one year, and the clinical data, operative and postoperative follow-up data of these two groups of patients were compared.Results The AFP level in group A was (810.4±80.4) ng/mL, which was significantly higher than that in group B (790.1±77.3) ng/mL (P<0.05), but there was no statistical difference in age, male, BMI, virus infection, Child-Pugh grade, ICG R15, past history and clinical stage between the two groups (P>0.05). The number of blood transfusion, postoperative complications and one-year overall survival rate in group A were 19 (19.2%), 7 (7.1%) and 66 (66.7%), which were significantly lower than those of 17 (36.9%), 10 (21.7%) and 38 (82.6%) in group B, respectively (P<0.05). In group A, the tumor recurrence rates in patients with MVI and in one-year post operation were 30 (30.3%) and 58 (58.6%) cases, respectively, compared with those of 4 (8.7%) and 13 (28.3%) cases in group B, the difference was statistically significant (P<0.05).Conclusion Compared with <1 cm group, the MVI and tumor recurrence rate after radical hepatectomy in HCC patients with width >1 cm group are lower, and the overall survival situation is better, but the numbers of postoperative complications and cases of blood transfusion are higher.
    The T lymphocyte and NK cell levels in patients with malignant pleural effusion after radical resection of primary hepatocellular carcinoma
    LI Jiao-jiao, ZHAO Yong-chang, WU Jun-xia
    2023, 28(8):  924-927. 
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    Objective To observe the levels of T lymphocytes and natural killer (NK) cells in patients with malignant pleural effusion after radical resection of primary liver cancer.Methods From March 2019 to March 2022, one hundred primary liver cancer patients with pleural effusion and ascites after radical resection who were admitted to the Second Hospital of Yulin City, Shaanxi Province were divided into a malignant group (n=24 cases) and a non-malignant group (n=76 cases) according to the nature of pleural effusion and ascites (i.e., malignant or benign). The levels of T lymphocytes and NK cells in pleural and ascites were detected. Receiver operating characteristic curve (ROC) was used to analyze the value of CD3+, CD3+CD4+, CD3+CD8+ and NK cell levels in the diagnosis of malignant pleural effusion. Spearman rank correlation coefficient was used to analyze the correlation between CD3+, CD3+CD4+, CD3+CD8+ and NK cell levels and the risk of malignant pleural effusion.Results The levels of CD3+, CD3+CD4+ and NK cells in the malignant group were (61.2±11.3)%, (67.2±13.1)% and (20.4±3.4)%, respectively, which were significantly lower than those of (75.3±9.9)%, (73.6±8.5)%, and (24.5±3.6)% in the non-malignant group (P<0.05). The level of CD3+CD8+ cells in the malignant group was (33.2±5.5)%, which was significantly higher than that of (26.3±6.1)% in the non-malignant group (P<0.05). According to ROC analysis, the area under the curve (AUC) and 95%CI of CD3+, CD3+CD4+, CD3+CD8+ and NK cells in the diagnosis of malignant pleural effusion were 0.874 (0.814~0.925), 0.653 (0.549~0.767), 0.843 (0.780~0.905) and 0.846 (0.786~0.910), respectively (P<0.05). The risk of malignant pleural effusion after radical resection of primary liver cancer was negatively correlated with the levels of CD3+, CD3+CD4+ and NK cells (r=-0.625, r=-0.517, r=-0.573, P<0.05), and positively correlated with the levels of CD3+CD8+ (r=0.582, P<0.05).Conclusion Patients with malignant pleural effusion after radical resection have more serious immune dysfunction than patients with non-malignant pleural effusion, which is mainly manifested by the decrease of the proportion of CD3+, CD3+CD4+ and NK cells and the increase of CD3+CD8+ cells. Clinical screening of patients with high risk of malignant pleural effusion can be performed by detecting T lymphocyte subsets and NK cell levels in pleural effusion.
    A clinical study for the therapeutic effect of arotinib on patients with stage III primary liver cancer after interventional therapy
    WANG Chun-hong, FENG Wei-wei, ZHANG Jing, SI Chen-fei
    2023, 28(8):  928-931. 
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    Objective To investigate the efficacy of transcatheter arterial chemoembolization (TACE) combined with arotinib on the treatment of stage III primary liver cancer.Methods 205 patients with stage III liver cancer who were treated in Hengshui Third People's Hospital from January 2020 to January 2023 were divided into a control group (n=103) and an observation group (n=102). After TACE therapy, patients in the observation group were administrated with arotinib and evaluated for the clinical efficacy.Results One month after surgery, the Karnofsky score was (79.5±8.0) in the observation group, which was higher than that of (75.3±8.3) in the control group (P<0.05). After treatment, the serum levels of alpha fetoprotein (AFP) and carcinoembryonic antigen (CEA) in the observation group were (558.82±49.87)ng/L and (33.89±5.45)ng/mL, respectively, which were significantly lower than those in the control group (P<0.05). Serum vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and γ-Glutamyle transferase (GGT) in the observation group were significantly lower than those in the control group (P<0.05); The disease control rate in the control group was 69.90%, while the disease control rate in the observation group was 88.23%, which was superior to the control group (χ2=11.959, P=0.008); There was no significant difference in adverse reactions between the control group and the observation group (P>0.05).Conclusion TACE combined with arotinib in the treatment of advanced liver cancer patients significantly improve clinical efficacy without increasing adverse reactions.
    A novel treatment on small hepatocellular carcinoma adjacent to large vessels by ultrasound assisted precision microwave ablation
    ZHANG Hai-rong, LI Jin-song, TIAN Xiu-li, HE Xin, JIANG Jue
    2023, 28(8):  932-934. 
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    Objective To observe the effect of a novel ultrasound technology assisted precise microwave ablation for small hepatocellular carcinoma adjacent to large vessels.Methods A total of 76 patients with small hepatocellular carcinoma near large blood vessels who were admitted to Xi'an Baoshihua Changqing Hospital were selected and divided into a control group (with surgical resection, n=36 cases) and a study group (with microwave ablation treatment assisted by new technology of ultrasound, n=40 cases) according to the different surgical regimes selected. The operation time, hospital stay, incidence of complications and 1month postoperative resection rate were compared between the two groups. The patients were followed up for 1 year, and the incidence of tumor progression and survival at 1 year after surgery were compared.Results The operation time and hospital stay in the study group were shorter than those of the control group [(92.45±15.28) min vs (138.41±28.35) min, and (6.12±1.47) d vs (10.06±2.13)d, respectively] (t=8.918, 9.463, all P<0.05). The incidence of complications during hospitalization in the study group (2.78% vs 17.50%) was lower (χ2=4.360, P=0.037). The surgical resection rates of the control group and the study group (2.78% vs 17.50%) were similar (χ2=1.849, P=0.174). The incidence of tumor progression at 1 year after operation in the control group and the study group was similar (16.67% vs 17.50%) (χ2=0.009, P=0.923). The 1-year survival rates of the control group and the study group were similar (83.33% vs 80.00%) (χ2=0.165, P=0.684).Conclusion The treatment of ultrasound technology assisted precise microwave ablation for small liver cancer adjacent to large vessels can achieve the same therapeutic effect as surgical resection, with shorter operation time and hospital stay, as well as relatively less complications.
    A correlation analysis between immune-related adverse events and the curative effect caused by immune checkpoint inhibitors on patients with advanced primary Hepatocellular carcinoma
    HU Zhi-qiang, MEN Fen-yong, LIU Dong
    2023, 28(8):  935-937. 
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    Objective To explore the relationship between immune-related adverse events (irAEs) in patients with advanced primary liver cancer during anti-PD-1/PD-L1 treatment and the efficacy of immunotherapy, and to provide clinical evidence for clarifying their correlation.Methods Between January 2019 and January 2022, eighty patients with advanced primary liver cancer were treated with PD-1/PD-L1 inhibitors alone or in combination, and the included cases met the requirements. The efficacy of PD-1/PD-L1 inhibitor was evaluated after treatment, and the irAEs and its severity during immunotherapy were evaluated according to the evaluation standard of common adverse events (CTCAE version 5.0).Results The immune checkpoint inhibitors (ICIs) used in these 80 patients with advanced primary liver cancer were Tereplizumab, Karelizumab, Cindilizumab and Pabolizumab. During the immunotherapy, 45 patients (56.2%) had 63 times of irAEs, of which 8 patients (10.0%) reported 11 times of irAEs ≥3, and the median time from ICIs treatment to the present of irAEs was 2.4 months. The common irAEs were reactive cutaneous capillary hyperplasia (23 times, 36.5%), rash/vitiligo (14 times, 22.2%), hypothyroidism (10 times, 15.9%), hepatitis (6 times, 9.5%), pancreatic injury (3 times, 4.8%), pneumonia (3 times, 4.8%) and diarrhea/colitis (2 times). In 45 patients with irAEs, complete response (CR), partial response (PR), stable disease (SD) and porgressive disease (PD) were 0 (0%), 18 (40.0%), 19 (42.2%) and 8 (17.8%), respectively. In 35 patients without irAEs, CR was 1 (2.8%) and PR was 5 (14.3%). The Objective response rate (ORR) of patients with and without irAEs was 40.0% (18/45) and 14.3% (5/35) respectively, and the difference was statistically significant (P<0.05). The disease control rate (DCR) of patients with and without irAEs was 82.2% (37/45) and 42.9% (15/35) respectively, and the difference was statistically significant (P<0.05). All cases were followed up, and the median follow-up time was 10.5 months. By the end of the follow-up, the median progression-free survival (PFS) of patients with and without irAEs was 10.4 months and 4.3 months, respectively, and the difference was statistically significant (P<0.05). The median overall survival (OS) of patients with and without irAEs was 17.6 months and 8.8 months, respectively, and the difference was statistically significant (P<0.05).Conclusion For patients with advanced primary liver cancer, treatment with PD-1/PD-L1 inhibitors shows good efficacy and safety. Meanwhile, there is a correlation between the occurrence of irAEs and the efficacy and clinical outcome of immunotherapy; thus, it is a potential marker to predict the efficacy.
    The value of diffusion weighted imaging of voxel incoherent motion in predicting microvascular invasion and evaluating the efficacy of TACE therapy on hepatocellular carcinoma
    XU Jia-pin, SHAO Chun-yan, LIU Di-fa, XU Ya-chun
    2023, 28(8):  938-942. 
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    Objective To investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIEM-DWI) in evaluating the preoperative condition and postoperative recurrence of hepatocellular carcinoma (HCC) patients undergoing hepatic arterial chemoembolization (TACE) therapy.Methods A total of 92 HCC patients who underwent TACE from July 2019 to June 2021 were selected for IVIM-DWI examination at 3 days before and 1 month after the surgery. The patients were divided into a microvascular invasion (MVI) positive group (n=60 cases) and a MVI negative group (n=32 cases) according to the pathological results of liver biopsy before TACE. One month after TACE therapy, the patients were divided into a stable group (n=49 cases) and a progressive group (n=43 cases) according to the efficacy evaluation. Six patients were followed up and divided into a recurrence group (n=27 cases) and a non-recurrence group (n=65 cases) according to MRI examination and tumor serological indicators. The tumor diameter, standard apparent diffusion coefficient (ADC), true apparent diffusion coefficient (D), false apparent diffusion coefficient (D*) and perfusion coefficient (f value) were compared between the MVI positive group and the MVI negative group before surgery, and the ADC, D value, D* value and f value after TACE were compared between the stable group and the progressive group, the recurrent group and the non-recurrent group. Logistic regression analysis was performed to analyze the single factors affecting the postoperative stability and recurrence of HCC patients. Receiver operating characteristic curve (ROC) was drawn to analyze the efficacy of imaging indicators in evaluating postoperative recurrence of TACE.Results Before TACE, the tumor diameter of MVI positive group was 5.61±0.94 cm, which was higher than that of negative group (4.03±0.76 cm), ADC value and D value were 0.87±0.15 and 0.82±0.24, which were lower than that of negative group (0.98±0.19 and 0.94±0.31). The difference was statistically significant (t=5.635, 4.518, 4.964, all P<0.05). The ADC and D values of the stable group after TACE were 1.28±0.47 and 1.48±0.52, which were higher than those of the progressive group (1.07±0.39 and 1.22±0.40), and the differences were statistically significant (t=5.374, 5.038, all P<0.05). The ADC value and D value in the recurrence group after TACE were 1.02±0.35 and 1.08±0.37, which were lower than those in the group without recurrence (1.36±0.51 and 1.59±0.56), and the difference was statistically significant (t=5.384, 5.897, all P<0.05). Logistic regression analysis showed that tumor diameter was negatively correlated with postoperative stability and positively correlated with postoperative recurrence in HCC patients. Postoperative ADC value and postoperative D value were positively correlated with postoperative stability, and negatively correlated with postoperative recurrence (both P<0.05). ROC curve showed that the AUC of tumor diameter, postoperative ADC value and postoperative D value for postoperative recurrence evaluation of TACE were 0.682, 0775 and 0.849, respectively, and the sensitivity and specificity were 79.56% and 77.28%, 82.73% and 79.67%, 84.51% and 82.49%, respectively. The difference was statistically significant (all P<0.05), and the evaluation efficiency of postoperative D value was better than that of tumor diameter and postoperative ADC value.Conclusion IVIEM-MRI has a higher value in evaluating MVI before operation, short-term efficacy after operation, and the prognosis of HCC patients. It also has better efficacy in evaluating D value after operation.
    Effect of fibronectin type III domain containing 5 on the metastatic activity of HepG2 hepatoma cells in vitro and its mechanism
    YUAN Qing-gong, ZHANG Yan, LI Jun-hui, YANG Wen-bin
    2023, 28(8):  943-946. 
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    Objective To investigate the effect of FNDC5 on hepatocellular carcinoma (HCC) and its related mechanisms in order to propose new ideas for the treatment of HCC.Methods HepG2 cells were divided into four groups based on FNDC5 concentration (0, 5, 10 and 20 μM). The activity, invasion and migration of HepG2 cells,as well as apoptosis rate, were analyzed by MTT test, colony formation test, Transwell test, flow cytometry and cell scratch test. The impact of FNDC5 on the Wnt/β-catenin pathway was analyzed by Western blot.Results FNDC5 reduced the growth activity of HepG2 cells (92.86±0.32 vs 79.32±0.17 vs 50.11±0.56 vs 29.29±0.96), inhibited HepG2 cell colony formation (238.25±12.28 vs 126.91±9.56 vs 68.93±9.25 vs 32.53±7.32), and prevented the occurrence of HepG2 cell invasion and migration (87.13±2.18 vs 66.23±2.16 vs 46.23±3.27 vs 22.56±5.12; 88.46±12.55 vs 55.08±9.21 vs 39.62±5.63 vs 19.26±5.71).FNDC5 also induced apoptosis in HepG2 cells (1.46±0.23 vs 5.08±0.11 vs 9.66±0.23 vs 13.27±1.01).Conclusion HepG2 cell metastatic activity can be inhibited by FNDC5, and the anti-tumor effect of FNDC5 may be connected to the Wnt/β-catenin signal pathway.
    Viral Hepatitis
    Therapeutic effect of entecavir or tenofovir combined with PEG-IFN α-2b on patients with chronic hepatitis B hypoviremia
    ZHANG Pei-yuan, LEI Xue, WANG Mei-yu
    2023, 28(8):  947-949. 
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    Objective To explore the effect of entecavir or tenofovir combined with PEG-IFN α-2b on treating patients with chronic hepatitis B hypoviremia.Methods From September 2017 to October 2021, 52 patients with chronic hepatitis B who had not previously received antiviral therapy were treated with entecavir or tenofovir combined with PEG-IFN α-2b for 48 weeks. The researchers compared the baseline characteristics, blood cell changes and virological changes of patients in entecavir group and tenofovir group.Results There were no significant differences between the two groups at baseline. Red blood cell count, lymphocyte count and neutrophil count showed a downward trend , but there was no significant difference between the two groups. At the 48th week of treatment, the negative conversion rates of HBeAg and HBV DNA in tenofovir group were 46.2% (12/26) and 84.6% (22/26), which were significantly higher than those of entecavir group [11.5% (3/26) and 57.7% (15/26) (P<0.05)].Conclusion In patients with HBeAg-positive chronic hepatitis B, treatment with tenofovir combined with PEG-IFN α-2b was better than treatment with entecavir combined with PEG-IFN α-2b after using PEG-IFN α-2b alone for 12 weeks.
    Clinical value analysis of serum macrophage inhibitory factor-1 level in patients with chronic hepatitis C (CHC) genotype 1b
    SONG Jie, NIE Hong, CHI Hui, GUO Rui-fang
    2023, 28(8):  950-952. 
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    Objective To investigate the effect of macrophage inhibitory factor-1 (MIC-1) level on chronic hepatitis C (CHC) genotype 1b by selecting appropriate cases.Methods A retrospective analysis of 84 patients with type 1b CHC from January 2016 to March 2019 was conducted, and the diagnosis of CHC was confirmed according to the standard scheme of CHC. All patients treated with pegylated interferon plus ribavirin, and different virological responses of patients were compared by univariate and multivariate analysis.Results Among the 84 patients with type 1b CHC, 61 cases had virological responses while 23 cases did not. The age of the responding group [45 (37, 55) years] in this study was significantly higher than that of the non-responding group [36 (33, 44) years, P<0.05]. The levels of ALT, AST, PⅢNP, CⅣ and MIC-1 in the responding group were 40 (15, 82) U/L, 37 (18, 94) U/L, 27.0 (10.1, 114.6) ng/mL, 28.4 (11.5, 108.4) ng/mL and 298.8(145.2, 746.8) pg/mL, which were significantly lower than those in the non-responding group [56 (26, 122) U/L, 49 (22, 120) U/L, 33.7 (11.3, 160.6) ng/mL, 36.7 (14.1, 170.1) ng/mL and 646.3 (156.7, 1540.3) pg/mL, P<0.05]. The MIC-1 [714.8 (171.0, 1582.1) pg/mL] of 84 patients with type 1b CHC before treatment was significantly higher than that after treatment [365.0 (159.9, 1004.0) pg/mL, P<0.05]. The MIC-1 of the response group before treatment [720.4 (184.7, 570.1) pg/mL] was also significantly higher than that after treatment [298.8 (145.2, 746.8) pg/mL, P<0.05]. However, there was no significant difference in the non-responding group before and after treatment [710.9 (161.2, 1532.7) pg/mL vs 646.3(156.7, 1540.3) pg/mL, P>0.05]. Taking the virological response status of patients with type 1b CHC as the dependent variable, multivariate Cox regression analysis was carried out on the data (age, ALT, AST, PⅢNP, C-Ⅳ and MIC-1) which were different in single factor analysis. The results showed that MIC-1 was an independent risk factor [HR=5.31 (95%CI: 2.74 ~ 11.52), P=0.008], which affected type 1b CHC.Conclusion Serum MIC-1 level is an independent risk factor that affects the virological response of patients with type 1b CHC and may be a potential diagnostic marker of HCV infection.
    Autoimmune Liver Disease
    Analysis of clinical and pathological features of acute autoimmune hepatitis
    ZHENG Mu-yang, HU Hai, FAN Xian-wen
    2023, 28(8):  953-956. 
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    Objective To analyze clinical and pathological features of acute autoimmune hepatitis.Methods 74 patients with AIH who were hospitalized and underwent liver biopsy from January 2012 to June 2022 in Jiangbin Hospital of Guangxi were enrolled. The patients included 13 males and 61 females, with a mean age of 53.2±8.7 years. The diagnosis of acute AIH needed to meet at least one of the following conditions: total bilirubin (TBil) ≥ 85.5 μmol/L; transaminase level (ALT/AST) ≥ 10 × the upper limit of normal value. The baseline data, laboratory indexes and pathological manifestations were analyzed.Results There were 32 cases of acute AIH and 45 cases of chronic AIH in 77 patients. There were no significant differences in sex, age, IAIHG score, extrahepatic autoimmune diseases and onset time between the two groups (P>0.05). However, patients with acute AIH had a significantly higher proportion of jaundice, anorexia, and yellow urine compared to patients with chronic AIH (P<0.05). The positive rates of TBil, ALT, AST, PT, INR, IgG and ANA titers in patients with acute AIH>1∶100 were 83.4 (47.8, 192.8) μmol/L, 237 (141, 352) U/L, 292 (168, 357) U/L, 15.1 (13.6, 16.5) s, 1.3 (1.1, 1.4), 30.2 (21.4, 33.3) g/L and 27 cases (84.4%), respectively, which were significantly higher than those in patients with chronic AIH [24.0 (13.2, 47.8) μmol/L, 44 (23, 94) U/L, 56 (34, 97) U/L, 12.8(11.7, 13.7) s, 1.1 (1.0, 1.1), 21.6 (17.6, 24.3) g/L and 23 cases (51.1%), P<0.05]. The Alb of patients with acute and chronic AIH was (34.2±3.0) g/L and (40.2±3.1) g/L, and the difference was statistically significant (P<0.05). Acute AIH was mainly characterized by acute hepatitis in histopathology. There were significant differences in inflammation grade, lobular inflammation, interfacial hepatitis, rosette, lymphocytes around portal vein, plasma cells, neutrophils, bile duct injury and lobular neutrophils between acute and chronic AIH patients (P<0.05), but there was no significant difference in liver fibrosis stage between them (P>0.05).Conclusion Acute AIH is mainly characterized by acute hepatitis. Clinical manifestations and serological examination can preliminarily distinguish acute AIH from chronic AIH. In histopathology, besides high inflammatory grade, interfacial hepatitis, rosette and inflammatory cells around the portal vein, acute AIH is prone to bile duct injury. Therefore, long-term follow-up should be paid attention to.
    Retrospective study of red blood cell distribution width-platelet ratio in evaluating the severity of liver fibrosis in patients with autoimmune hepatitis
    CHEN Li-xia, SHEN Li-lei, ZHENG Yi
    2023, 28(8):  957-960. 
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    Objective To compare the clinical data of patients of autoimmune hepatitis (AIH) and drug-induced liver injury (DILI), and then to evaluate the associated factors of liver fibrosis severity and the diagnostic efficiency of AIH patients.Methods From June 2015 to August 2022, 45 patients with AIH (AIH group) were reviewed, including 4 males and 41 females. 86 patients with DILI (DILI group) were also included (23 males and 63 females). Metavir system was used to score the degree of hepatic fibrosis, in which < F2 stage was defined as non-significant hepatic fibrosis, and ≥F2 stage was significant hepatic fibrosis. The clinical data of the two groups were compared, and univariate and multivariate analysis were used to analyze the associated factors of advanced hepatic fibrosis in AIH patients. ROC curve and AUC value were used to evaluate the accuracy of red blood cell distribution width-Platelet (RPR) in the diagnosis of AIH liver fibrosis severity.Results In AIH patietnts, the age, skin pruritus, ALP, globulin, TBA, PT and RDW of AIH patients were 54 (48, 63) years old, 6 cases (13.3%), 154 (119, 278) U/L, 36.1 (31.2, 44.0) g/L, 50.4 (17.8, 140.6) μmol/L, 11.8 (11.2, 13.4) s and 15.1 (13.6, 16.4)%, which was significantly higher than that of DILI [50 (41, 58) years old, 0 (0), 121 (82, 187) U/L, 28.3 (24.6, 31.8) g/L, 25.6 (8.9, 108.4) μmol, 11.2 (10.8, 12.3) s and 14.1(13.0, 15.5) %, respectively, P<0.05]. In AIH patients, PLT was 4 cases (8.9%) and 162 (126, 203) × 109/L, which were significantly lower than those in DILI [23 cases (26.7%) and 204 (173, 352) × 109/L, P<0.05]. Univariate analysis showed that IgA, RDW, FIB-4, GPR and RPR were significant associated with significant hepatic fibrosis in AIH patients. Multivariate analysis showed that increased IgA, GPR and RPR levels, were significant associated with significant hepatic fibrosis, while age, sex, IgG, RDW, APRI and FIB-4 had no significant correlation with significant hepatic fibrosis in AIH patients. The cutoff point, ROC value, sensitivity and specificity of RPR for AIH patients with significant liver fibrosis were -2.3, 0.82, 82.3% (14/17) and 78.6% (22/28), respectively.Conclusion RPR and serum IgA levels were significantly related to .histological liver fibrosis in patients with AIH.
    Relationship between serum ferritin level and advanced hepatic fibrosis in newly diagnosed autoimmune hepatitis
    PEI Yu-mei, ZHANG Zhi-hui, LIAN Li-li
    2023, 28(8):  961-964. 
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    Objective To investigate the relationship between serum ferritin level and liver fibrosis in patients newly diagnosed with autoimmune hepatitis (AIH).Methods A total of 92 patients with AIH who had undergone liver biopsy before receiving immunosuppressive therapy from January 2012 to June 2022 were reviewed. The patients consisted of 15 males and 77 females, with a mean age of 54.0±11.3 years. The assessment of hepatic fibrosis stages was based on Batts-Ludwig scoring system, in which F3 and F4 stages were defined as advanced hepatic fibrosis, and F0-F2 stages were non-advanced hepatic fibrosis. The clinical data of the two groups and the correlation among the data were compared, and the factors that affect the advanced hepatic fibrosis of AIH were analyzed.Results Based on the results of liver biopsy, the patients were divided into non-advanced fibrosis group (n=57) and advanced fibrosis group (n=35). In AIH patients, the age, IgG, TBil, PT, ferritin and TSI of non-advanced fibrosis group were (51.0±11.8) years old, 14.9(12.8, 18.9)g/L, 17.1(11.6, 32.7)μmol/L, (12.2±1.0)s, 124.3(44.6, 305.4)μg/L and 33.2(23.0, 57.8)%, respectively, which were significantly lower than those in advanced hepatic fibrosis group [(58.1±9.3) years, 18.5(15.8, 24.2)g/L, 28.2(15.7, 92.7)μmol/L, (13.9±1.2)s, 352.7(183.0, 740.6)μg/L and 55.0(41.2, 69.8)%, P<0.05]. While in the non-advanced fibrosis group, Alb, PLT, transferrin, UIBC and TIBC [(41.0±4.8) g/L, (210.4±36.5) × 109/L, 2.7(2.3, 3.2)g/L, 39.0(23.4, 51.2) and 64.0(56.5, 71.0)]μmol/L were significantly higher than those of advanced hepatic fibrosis group [(38.1±5.1) g/L, (122.3±23.5) × 109/L, 2.4(2.1, 2.8)g/L, 25.1(16.3, 31.4)μmol/L and 55.6 (50.6, 60.8)μmol/L, P<0.05]. Correlation analysis showed that serum iron was positively correlated with ferritin and TSI (r=0.44, 0.93) (P<0.05), and negatively correlated with transferrin, UIBC and TIBC (r=-0.44, -0.82, -0.25) (P<0.05). Serum iron, ferritin and TSI were positively correlated with age, TBil and hepatic fibrosis stage (r=0.30, 0.49, 0.24; 0.34, 0.39, 0.40; 0.37, 0.52, 0.29) (P<0.05), while transferrin, UIBC and TIBC were negatively correlated with age, TBil and fibrosis stage (r=-0.41, -0.22, -0.24; -0.38, -0.52, -0.94; -0.36, -0.25, -0.48, P<0.05). Serum iron, ferritin and TSI were positively correlated with ALT and AST (r=0.34, 0.45; 0.42, 0.47; 0.33, 0.45) (P<0.05), while UIBC was negatively correlated with ALT and AST (r=-0.31, -0.40) (P<0.05); serum iron and TSI were negatively correlated with Alb and PLT (r=-0.39, -0.20) (P<0.05), while transferrin, UIBC and TIBC were positively correlated with Alb and PLT (r=0.35, 0.34; 0.53, 0.33; 0.40, 0.39) (P<0.05); there was a positive correlation between TSI and PT (r=0.23) (P<0.05), and a negative correlation between TIBC and PT (r=-0.22) (P<0.05). Multivariate analysis showed that IgG, PLT, PT and ferritin were independent factors to predict advanced liver fibrosis in patients with AIH, and the odds ratios (OR)(95%CI) were 1.10 (1.03~1.21), 0.98 (0.97~0.99), 1.73 (1.16~2.68) and 1.02 (1.01~1.04), respectively.Conclusion The increased serum ferritin level in newly diagnosed AIH patients is independently related to advanced hepatic fibrosis.
    Clinical characteristics and prognosis of patients with primary biliary cholangitis complicated with or without autoimmune diseases
    WEI Wei, WANG Yu, JIN Hang-bin, ZHENG Yi-nong
    2023, 28(8):  965-967. 
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    Objective To evaluate the clinical characteristics and prognostic factors in patients with primary biliary cholangitis (PBC), focusing on those with concurrent autoimmune diseases (ATD) in the PBC patient population.Methods A retrospective analysis was conducted on 152 PBC patients,who were admitted between September 2008 and December 2018. The cohort consisted of 17 males and 135 females, aged 52 (41, 64) years. All patients met the diagnositic criterria for PBC and received treatment with ursodeoxycholic acid(UDCA). Clinical data and prognostic outcomes between PBC patients without concurrent autoimmune diseases and those with concurrent autoimmune hepatitis(PBC-AIH) or Sjogren Syndrome(PBC-SS) were compared.Results Out of 152 evaluated cases of PBC, 104 cases were identified as isolated PBC (68.4%), 11 as PBC-AIH(7.2%), and 24 as PBC-SS (15.8%). Additionally, 3 patients were diagnosed with rheumatoid arthritis (2.0%), 2 with systemic lupus erythematosus, 2 with Graves' disease and 2 with coexisting AIH and SS (1.3%). In comparing isolated PBC with PBC-AIH, the PT was significantly different at 12.0 (11.1, 13.9) s and 12.8 (11.7, 17.3) s, respectively(P<0.05) Similarly, ANA(+) was significantly different between isolated PBC and PBC-AIH, with 55 cases (52.9%) and 9 cases (81.8%), respectively (P<0.05). Furthermore, comparisons of WBC, Hb, Alb and HDL levels were made between isolated PBC and PBC-SS groups. In the isolated PBC group, these values were 4.5 (3.4, 6.2)×109/L, 114.2 (106.1, 128.4) g/L, 34.6 (29.8, 38.7) g/L and 1.1 (1.0, 1.5) mmol/L. 17.0) g/L,respectively. In the PBS-SS group, these values were 3.2 (2.6, 4.2)×109/L, 111.2 (79.8, 117.0) g/L, 33.3 (28.2, 36.5) g/L and 0.9 (0.5, 1.2) mmol/L] respectively, revealing statistically significant differences(P<0.05). Survival data were collected up to January 1st, 2022. The median survival times for patients with isolated PBC, PBC-AIH and PBC-SS were 72.0, 58.5 and 50.0 months, respectively. The median survival time of patients with isolated PBC was significantly longer than those with PBC-AIH and PBC-SS (P<0.05). Similarly, the 5-year survival rate for patients with isolated PBC (80.8%) was significantly higher than for patients with(63.6%) and PBC-SS(58.3%) (P<0.05).Conclusion AIH emerges as the most prevalent hepatic complication among PBC patients, whereas SS stands out as the dominant extrahepatic complication. When PBC becomes complicated with ATD, it poses a detrimental impact on patients' clinical prognosis.    
    Diagnostic value of GLDH and GLDH/ALT levels in peripheral blood for staging primary biliary cholangitis
    WANG Lan, YANG Fan, QIU Hong, ZHANG Wei-wei, GU Chang, ZHU Yue-rong
    2023, 28(8):  968-972. 
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    Objective To investigate the diagnostic utility of the GLDH/ALT ratio in staging primary biliary cholangitis(PBC), by quantifying peripheral blood GLDH levels across pathological stages in PBC patients.Methods A total of 212 PBC patients with definitive pathological staging were included in the study. The peripheral blood GLDH levels of the participants were measured, and a series of non-invasive serological indicators such as FIB-4, APRI, AAR, and RPR were calculated. Spearman correlation analysis was performed to Explore the correlation between these various indicators and PBC staging. Diagnostic efficacy was evaluated by employing logistic binary regression analysis and constructing revervier operating characteristic(ROC) curves.Results There was no significant difference in GLDH and GLDH/ALT levels among patients in stage Ⅰ/Ⅱ (P>0.05); The levels of GLDH and GLDH/ALT were statistically significant between patients at stages Ⅱ/Ⅲ and stages Ⅲ/Ⅳ (P<0.05); There were no significant correlations between the pathological staging of PBC and the levels of ALT, GGT, and GPRI (r=0.006, P=0.152/r=-0.036, P=0.182/r=0.340, P=0.055); Positive correlations were observed between PBC pathologica staging and TBil (r=0.401, P=0.009), DBil (r=0.403, P=0.007), AST (r=0.217, P=0.019), RDW (r=0.422, P<0.001), FIB-4 (r=0.774, P<0.001), APRI (r=0.620, P<0.001), AAR (r=0.359, P<0.001), and RPR (r=0.742, P<0.001), whereas it was negatively correlated with PLT (r=-0.719, P<0.001); Levels of GLDH (r=0.162, P=0.007) and GLDH/ALT (r=0.203, P<0.001) in peripheral blood were positively correlated with PBC pathological staging. FIB-4 showed the best diagnostic efficacy for each stage of PBC, with AUC values of 0.821, 0.813, and 0.823, respectively; Among PBC patients at ≥ S1 stage, GLDH/ALT exhibited the highest sensitivity (93.75%), FIB-4 displayed the highest sensitivity (80.00%, 93.75%) at ≥ S2 and ≥ S3 stages, while APRI and RPR showed the best specificity at ≥ S1/≥ S2 stages (85.45%, 92.19%) and ≥ S3 stage (88.52%), respectively. Following the combination of multiple indicators, the diagnostic effectiveness (AUC=0.931/0.878) and sensitivity (82.81%/81.67%) of FIB4+APRI+AAR+GLDH+GLDH/ALT were enhanced for ≥ S2 and ≥ S3, respectively. The combination of FIB4+APRI+AAR+GLDH+GLDH/ALT demonstrated the highest specificity (92.73%) for diagnosing PBC at stage≥ S2, while FIB4+GLDH+GLDH/ALT showed the highest specificity (87.5%) for diagnosing PBC at stage ≥ S3.Conclusion The levels of GLDH and GLDH/ALT in peripheral blood present a certain diagnostic value for staging PBC, exhibiting a postive correlation. Moreover, the integration of multiple non-invasive serological indicators enhances the diagnostic efficacy.
    Other Liver Diseases
    Analysis of risk factors and clinical features of intrahepatic cholestasis in twin pregnancies
    SU Shuang-yan, CHEN Yuan-yuan, CHEN Xian-xia
    2023, 28(8):  973-976. 
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    Objective To explore the risk factors of intrahepatic cholestasis (ICP) in twin pregnancies and analyze its clinical features.Methods In this study, twin-pregnancy women who delivered in the Department of Obstetrics and Gynecology at our hospital between October 2019 and October 2021 were recruited, and were divided into ICP group (n=37) and non-ICP group (n=193); In the ICP group, 37 perinatal women were randomly selected,for data collection. The information on various biochemical markers including total bile acid (TBA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were recorded. Along with these data, the fetal prognosis for each case was also recorded.Results Out of the total subjects, 37 cases(16.09%) had ICP; of these, 34 cases were mild ICP, and 3 cases were severe,ICP occurrence was observed at different stages of gestation: 5 cases before 28weeks, , 7 cases between 28-32 weeks, and 25 cases beyond 32 weeks. Univariate analysis revealed that the incidence of ICP in pregnant women with twin pregnancies was significantly associated with a personal or family history of ICP, pre-pregnancy Body Mass Index(BMI) and weight gain during pregnancy (P<0.05). Moreover, weight gain was identified as an independent risk factor for ICP in twin pregnancies (P<0.05); The ICP group showed significantly higher rates of fetal distress (21.62%), meconium-stained amniotic fluid (13.51%), premature birth (35.14%) and transfer to the Neonatal Intensive Care UnitNICU (24.32%) compared to the non-ICP group (P<0.05). However, there was no significant difference in the incidence of aspiration pneumonia and neonatal death between the two groups (P>0.05); The levels of serum TBA (23.49±12.91 μmol/L) , ALT (71.01±61.04 U/L), AST (68.25±56.37 U/L), TBil (12.17±5.44 μmol/L) and LDL-C (4.67±1.44 mmol/L) in the ICP group were elevated compared to the non-ICP group, Conversely, HDL-C level (1.77±0.39 mmol/L) was lower in the ICP group (P<0.05).Conclusion The incidence of ICP in women with twin pregnancies is notably high, Key influencing factors include a personal or family history of ICP, pre-pregnancy BMI, and increased weight gain during pregnancy. Additionally, the presence of ICP significantly elevates the risk of complications such as fetal distress, meconium-stained amniotic fluid, preterm birth and the need for transfer to the NICU.
    Evaluating the severity of intrahepatic cholestasis of pregnancy and fetal growth restriction: The combined role of serum MMP-9, AFABP and PLGF levels
    LI Juan, SHEN Xiao-ya, ZHENG Li
    2023, 28(8):  977-982. 
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    Objective To investigate the clinical significance of serum matrix metalloproteinase-9 (MMP-9), adipocytic fatty acid-binding protein (AFABP) and placental growth factor receptor (PLGF) levels in assessing the severity of intrahepatic cholestasis of pregnancy (ICP).Methods From January 2020 to June 2022, 70 pregnant women diagnosed with ICP were selected as the observation group, while 40 healthy pregnant womenfrom the same period as the control group. Serum levels of MMP-9, AFABP, PLGF, alanine aminotransferase (ALT), albumin (Alb), total bilirubin (TBil), total bile acid (TBA) and glycholic acid (CG) were detected. The severity of pruritis was evaluated using the Ribalta score. According to TBA and TBil levels, the participants were divided into mild(n=31) , moderate(n=24) and severe(n=15)group. Based on the presence or absence of FGR, they were further classified into non-combined FGR(n=57) and combined FGR(n=13) subgroups. We compared levels of ALT, Alb, CG, MMP-9, AFABP and PLGF between the observation and control groups, and among the subgroups with different disease severities and FGR status within the observation. Pearson correlation was used to analyze the relationship between levels of MMP-9, AFABP , PLGF, ALT, Alb, CG and the Ribalta score. The effectiveness of single and combined detection was evaluated using ROC analysis.Results In the observation group, the levels of ALT, CG, MMP-9 and AFABP were 150.43±13.65 U/L, 17.52±4.28 mg/L, 786.38±62.85 ng/mL, 35.80±6.47 μg/L, respectively. The PLGF level in the observation group was 1.47±0.39 ng/mL, siginificantly lower than the control group`s levels(36.74±5.28 U/L, 1.86±0.37 mg/L, 542.71±48.93 ng/mL, 21.38±4.65 μg/L) (t=12.056, 19.825, 10.734, 9.428, 8.529, all P<0.05). Within the observation groups, the moderate to severe subgroup had higher MMP-9 and AFABP levels(852.86±70.25 ng/mL and 41.09±8.13 μg/L, respectively) than the moderate and mild subgroups(773.90±61.49 ng/mL, 36.47±6.70 μg/L, 680.47±53.42 ng/mL, 30.82±5.34 μg/L, respectively). The severe subgroup had a lower PLGF level(1.15±0.29 ng/mL) compared to the moderate and mild subgroups(1.43±0.38 ng/mL and 1.76±0.45 ng/mL, respectively), with these differences being statistically significant (F=24.825, 38.764, 28.492, all P<0.05). Moreover, In the observation group, the FGR subgroup had higher MMP-9 and AFABP levels(863.78±72.54 ng/mL and 41.37±8.26 μg/L, respectively), and a lower PLGF level(1.13±0.28 ng/mL) compared to the non-FGR subgroup (735.64±58.91 ng/mL, 33.61±6.25 μg/L and 1.61±0.42 ng/mL, respectively), with these differences also being, statistically significant (t=8.736, 9.872, 9.034, all P<0.05). Pearson analysis showed that the levels of MMP-9 and AFABP were positively correlated with ALT, CG and Ribalta scores in the observation group, while,PLGF levels had a negatively correlation(P<0.01). ROC analysis revealed that the AUC for MMP-9, AFABP and PLGF, both individually and combined were 0.684, 0.753, 0.709 and 0.921, respectively. The sensitivity and specificity of combined detection surpassed those of any single detection (P<0.01).Conclusion Simultaneously assessing serum levels of MMP-9, AFABP and PLGF offer significant clinical utility in determining the severity of ICP and the incidence of FGR.
    Effects of endoscopic ultrasound-guided percutaneous aspiration sclerotherapy on serum inflammatory factors in patients with hepatic cysts
    WU Jian, WANG Lian-cai, WANG Ya-feng, DU Chang-shun, XIAO Jian-an
    2023, 28(8):  983-986. 
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    Objective To investigate the effects of endoscopic ultrasound (EUS)-guided aspiration combined with sclerotherapy on serum inflammatory factors in patients with hepatic cysts.Methods From June 2020 to June 2022, 90 patients with hepatic cysts were admitted to our hospital. These patients were randomly divided into control group and observation group, with each group comprising 45 patients, The control group underwent sclerosing agent injection, while the observation group received EUS-guided percutaneous aspiration sclerotherapy, for a duration of 48 weeks. The levels of blood biochemical indexes and inflammatory factors between the two groups pre-treatment and 7 days post-treatment were compared. Further more, the total effective rate and the incidence of adverse reactions 12 weeks post-treatment in both groups were analyzed. Lastly, the recurrence rate of hepatic cysts 48 weeks after treatment in both groups was observed in the two groups.Results At the 12-week post-treatment mark, the observation group showed a higher total effective rate of 95.56% compared to the control group`s 82.22%e (P<0.05). There were no significant differences in ALT, AST, ALP and TBil between the two groups 7 days post-treatment (P>0.05). In the observation group, the serum levels of CRP, TNF-α and IL-1β were significantly lower[(53.83±6.24) mg/L, (260.80±18.40) ng/L and (91.04±5.10) ng/L, respectively] than those in the control group [(56.67±5.96) mg/L, (268.92±16.93) ng/L and (93.22±4.87) ng/L, P<0.05]. The incidence of adverse reactions in the observation group (2.22%) was also lower than that in the control group (17.78% , P<0.05). At the end of the 48-week post-treatment period, the observation group showed a lower recurrence rate of hepatic cysts( 2.27%) compared to the control group(17.95%, P<0.05).Conclusion In comparison to sclerotherapy injection alone, EUS-guided percutaneous aspiration sclerotherapy proves to be more effective for hepatic cysts. This approach can mitigate inflammation, diminish the incidence of complications and recurrence, without significantly impacting liver function.