The relationship between conventional liver tests, quantitative function tests, and histopathology in cirrhosis

Area of Science:

• Hepatology
• Biochemistry
• Diagnostic Medicine

Background:

• Cirrhosis significantly impairs liver function.
• Accurate assessment of remaining liver function is crucial for patient management.
• Conventional liver tests may not always reflect the functional parenchymal mass accurately.

Purpose of the Study:

• To evaluate the utility of the 2-hour [14C]aminopyrine breath test in patients with cirrhosis.
• To compare the aminopyrine breath test scores with conventional liver function tests and liver biopsy findings.
• To determine if the aminopyrine breath test can provide a quantitative estimate of functioning liver mass.

Main Methods:

• Thirty patients with cirrhosis underwent the 2-hour [14C]aminopyrine breath test.
• Liver biopsies were performed on 24 patients to assess necroinflammatory activity.
• Aminopyrine scores were correlated with liver biopsy results and conventional liver tests, including prothrombin time and SGOT.

Main Results:

• A good correlation was observed between necroinflammatory activity on liver biopsy and 2-hour aminopyrine scores.
• Patients with grade 2 or higher necroinflammatory activity showed abnormal prothrombin times and low aminopyrine scores (<2%).
• The 2-hour aminopyrine score correlated well with prothrombin time but not with SGOT or other liver tests.

Conclusions:

• The 2-hour [14C]aminopyrine breath test, along with prothrombin time, appears to be a reliable indicator of the total functioning parenchymal mass in cirrhosis.
• These tests are less affected by hepatocellular disease compared to other commonly used liver function tests.
• The aminopyrine breath test offers a valuable quantitative assessment of liver function in cirrhotic patients.