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Description
Histopathological Patterns of Liver Biopsies in Ghana: A Retrospective Study
Authors: Bernard Petershie1,2, Yolanda Ashie1,2, Richmond N. Y. Yeboah1, Vera A.S. Ghomli
Faith Asasenkasa1, Kafui Akakpo3.
Institutions:
KNUST (1), KATH (2), UCC (3)
Abstract
Background: Liver diseases constitute a critical health problem in Ghana, where conditions such as hepatocellular carcinoma, metastatic tumours, and benign disorders of the liver cause significant suffering and mortality. Liver biopsy remains the gold standard for accurately diagnosing and staging liver diseases. However, the increasing reliance on non-invasive modalities, particularly abdominal ultrasound, has significantly reduced the frequency of liver biopsies, thereby limiting access to information that could have been derived from liver biopsies. This study seeks to analyse liver biopsies in terms of their prevalence, distribution, and histopathological characteristics among a Ghanaian cohort. Further, the study investigates the demographic factors associated with malignant and benign lesions to provide valuable clues to understanding the disease patterns and their management implications.
Methods: In this study, we performed a retrospective review of 167 liver biopsy reports from
a private pathology laboratory in Accra for the period between 2021 and 2024. Demographic
and clinical data were evaluated, and a chi-square test was used to examine associations
between lesion type and demographic variables with p value, 0.05 denoting significance.
Results: Neoplastic lesions comprised 82.0% of samples, with about 94.9% found to be
malignant. HCC was the commonest primary malignancy, closely followed by metastatic
adenocarcinoma. Non-neoplastic conditions accounted for 18.0% of the samples, of which
chronic hepatitis and cirrhosis were the predominant causes. Primary malignancies occurred
more in males, whereas metastases were more common in the females, specifically in the
form of adenocarcinomas. Rare entities such as hepatic leiomyoma and paediatric
hepatocellular carcinomas were also identified.
Conclusions: The results of this study call for improved early detection and specific management strategies, especially considering the preponderance of malignant neoplasia. The
significant demographic variabilities found by this study underscore the importance of
targeted surveillance in high-risk subgroups. Improved biopsy techniques and non-invasive
modalities could optimize diagnosis and outcome for the patient.
Keywords: Liver biopsies, hepatocellular carcinoma