Primary evolution of chronic hepatitis estimated 3 to 14 years after the liver biopuncture

From over 800 patients with chronic hepatic diseases admitted to the Institute of Internal Medicine between 1960-1969 and in whom diagnosis was assessed by hepatic biopuncture, 180 were reexamined 3-14 years later to estimate the clinical evolution and the prognostic value of the bioptic findings. The evolution was favourable in most of the cases of persistent chronic hepatitis (70%) and of moderate aggressive chronic hepatitis (59%). Severe aggressive chronic hepatitis evaluated favourably in 34% of the cases and was aggravated in 42% of the cases (26% exits). In the patients with cirrhosis the percentage of deaths reached 65 but 30% were still in a stationary form; a single exceptional case was improved 7 years after the hepatic biopuncture. The prognostic value of hepatic biopuncture is much increased if, in addition to the common histological features, other histochemical and morphological criteria such as: structural stability of collagen fibers, importance of cellular infiltrates and presence of plasma cells, nuclear changes, degree of steatosis, amount of glycogen storage, siderosis and cholestasis are also taken into consideration.