[Clinical features and pathological scoring analysis of hepatic amyloidosis]

Objective: To explore the relationship between clinical manifestations and pathological features so as to provide a theoretical basis for the assessment of the condition in patients with hepatic amyloidosis. Methods: Twelve patients diagnosed with hepatic amyloidosis at the Second Hospital of Nanjing City from 2018 to 2024 were included. General condition, clinical manifestations, pathological features, and prognostic status were analyzed. Hematoxylin-eosin staining was performed on liver biopsy specimens to assess the pathological features of amyloidosis. The area of amyloidosis relative to the area of liver biopsy tissue in random fields was used as the score for the degree of liver degeneration. The Child-Pugh score was used to assess the patients' clinical phenotype. Data analysis was performed using R4.4.2 software. Univariate logistic regression and Spearman analysis were conducted. Results: Of the twelve cases, one was female and eleven were male, with a median age of onset of 63.5 (62, 65) years. All patients presented with fatigue, poor appetite, and hepatomegaly. Liver function tests showed cholestatic liver injury. Six patients had a Child-Pugh score of A, while six had a B or C. Four had a pathological score of two, while eight had a score of three. Univariate logistic regression analysis and Spearman analysis showed no correlation between the degree of pathological damage and the patients' clinical indicators or Child-Pugh scores. Conclusion: Patients presenting with fatigue, poor appetite, hepatomegaly, and cholestatic liver injury should be further differentiated from amyloidosis after ruling out other necessary common causes in clinical practice. To prevent any delay in therapy, clinicians should accurately evaluate the patient's condition for liver biopsy tolerance and conductance.