Abstract: Objective The aim of this study was to investigate the liver pathological features of patients with drug-induced liver injury(DILI). Methods Thirty-eight patients with DILI was encountered in our hospital between January 2017 and December 2020, and all were evaluated by structured expert opinion process(SEPO)and underwent liber biopsies. The diagnostic performance of DILI-pathological scroring system (DILI-PSS) was verified by the area under the receiver operating characteristic curve (AUROC). Results Out of the 38 patients with DILI, 14 patients (36.8%) had taken chemical medicines and biological products, 12 patients (31.6%) had taken Chinese herbal medicines, 9 patients (23.7%) had taken Chinese herbal, chemical medicines and biological products, and 3 patients (7.9%) had taken dietary supplements; the pathological examination showed that hepatic steatosis in 20 cases(52.6%), hepatic cholestasis in 22 cases(57.9%), bile duct damage in 15 cases(39.4%), eosinophil immersion in 11 cases(28.9%), hepatocellular wreaths in 9 cases (23.7%), and granuloma in 6 cases (15.8%); the AUROC was 0.775 with 95% confidence interval of 0.669-0.880 (P<0.05), and the sensitivity of 81.6% and the specificity of 65.8% when the DILI-pathological scroring system (DILI-PSS) was applied to predict the diagnosis. Conclusion The application of DILI-PSS might help diagnose patients with DILI, which needs further clinical investigation.

Key words: Drug-induced liver injury, Histopathology, Roussel Uclaf causality assessment method, Drug-induced liver injury -pathological scroring system, Diagnosis