Abstract: Objective This study was conducted to analyze the etiological diagnosis and hepatic histological manifestations of patients with noncausal chronic abnormal liver biochemical tests (NCALBT). Methods We retrieved and retrospectively analyzed clinical materials of a series of 248 patients with NCALBT at presentation. All patients underwent liver biopsies and evaluated according to Scheuer scores. Blood biochemical, serologic and virologic detections were recorded. Results Out of 248 patients with NCALBT, the diagnosis based on comprehensive materials included drug-induced liver injury (DILI) in 89 cases(35.9%), autoimmune liver diseases (AILD) in 67 cases (27.0%), nonalcoholic fatty liver diseases (NAFLD)in 39 cases(15.7%), inherited metabolic liver diseases (IMLD)in 30 cases (12.1%), idiopathic non-cirrhotic portal hypertension (INCPH) in 20 cases (8.1%) and other liver diseases in 3 cases (1.2%); common serum biochemical parameters in patients with DILI and AILD were significantly higher than in patients with NAFLD or INCPH (P<0.05); 67.8% of patients in our series had liver injuries at G_2-4/S_2-4 states, showing definite liver tissue injuries, and 61.8% of DILI, 95.5% of AILD, 56.4% of NAFLD, 65.0% of INCPH and 100.0% of other liver diseases had liver injuries at G_2-4/S_2-4, while the G_2-4/S_2-4 liver tissue activity accounted for 36.7% in patients with IMLD. Conclusion The etiologies of patients with NACLBT is still common diseases, and the diagnosis might be made based on comprehensive biochemical, serologic, virologic and liver tissue examinations.

Key words: Noncausal chronic abnormal liver biochemical tests, Etiologyical diagnosis, Histological manifestations