ArticleHepatology forum2026
Shifts in liver biopsy indications and histopathological diagnoses: A report from a tertiary care center in Türkiye.
Article in Hepatology forum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aim: Despite advances in non-invasive methods, liver biopsy remains essential for diagnosis, prognosis, and treatment planning, and this study aimed to evaluate trends in its indications and pathological findings. Materials and Methods: A total of 1533 adult liver biopsies at a tertiary referral hospital (2000-2022) were retrospectively reviewed for indications and diagnoses. Results: The annual number of liver biopsies performed remained stable over the last two decades (730 vs. 803; p=0.06). The mean patient age was 43±15 years, with 52% being female. The leading indications were abnormal liver function tests (53.4%), fibrosis/cirrhosis (40.9%), treatment follow-up (2.7%), hepatomegaly (1.6%), and fever of unknown origin (0.9%). Between 2000-2011 and 2012-2022, the indications for liver biopsy changed significantly: biopsies for fibrosis/cirrhosis increased, whereas those for evaluation of treatment response and disease monitoring and for hepatomegaly decreased (p=0.01, p<0.001, and p=0.02, respectively). In the post-COVID-19 period, abnormal liver function tests became the predominant indication (42.2% vs. 69.2%), whereas fibrosis/cirrhosis decreased (54.2% vs. 28%). The most frequent pathological diagnosis was chronic hepatitis B virus (HBV) infection (38.6%), followed by chronic hepatitis C virus (HCV) (11.5%), metabolic dysfunction-associated steatohepatitis (MASH) (8.5%), autoimmune hepatitis (AIH) (7.7%), and primary biliary cholangitis (PBC) (4.2%). Across decades, MASH (6.4% vs. 10.3%; p=0.008), AIH (4% vs. 11.1%), and PBC (1.1% vs. 7%) increased significantly (p<0.001), while chronic HCV declined (17.3% vs. 6.1%; p<0.001). Chronic HBV remained stable (38.2% vs. 38.9%). Conclusion: Over the past 22 years, the annual number of liver biopsies remained stable, with abnormal liver function tests as the leading indication, a decline in fibrosis/cirrhosis evaluation, chronic hepatitis B as the most common diagnosis, and a gradual rise in autoimmune liver diseases and MASH.
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