Correlation of Liver Enzymes and Blood Parameters With Histopathological Severity in Benign and Malignant Liver Lesions.

BACKGROUND: Liver lesions, whether benign or malignant, often present with nonspecific clinical features, making early diagnosis and prognostication challenging. Histopathological evaluation remains the gold standard, but serum biomarkers could offer non-invasive alternatives for assessing disease severity. OBJECTIVES: This study aimed to evaluate the role of liver enzymes and hematological parameters in differentiating benign from malignant liver lesions and to correlate these markers with histopathological severity. METHODOLOGY: A prospective observational study was conducted at Ayub Medical College, Abbottabad, Pakistan, from January to December 2024, involving 120 patients with radiologically confirmed liver lesions. Blood samples were analyzed for alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total and direct bilirubin, hemoglobin, leukocyte count, platelet count, and erythrocyte sedimentation rate (ESR) using standard laboratory protocols. Histopathological grading of malignant lesions was performed on hematoxylin and eosin (H&E)-stained sections. Independent t-tests and one-way analysis of variance (ANOVA) were applied to assess group differences, and Pearson's correlation analysis was used to examine associations with tumor grade. RESULTS: Among 120 patients, 72 (60%) had malignant and 48 (40%) had benign liver lesions. Malignant lesions demonstrated significantly elevated ALT, AST, ALP, and bilirubin levels, along with lower hemoglobin and higher leukocyte counts and ESR (p < 0.001 for all). These parameters also showed significant progressive changes across low-, intermediate-, and high-grade malignancies. Strong positive correlations were found between histopathological grade and ALT (r = 0.61), AST (r = 0.68), ALP (r = 0.59), and ESR (r = 0.71), while hemoglobin showed a strong negative correlation (r = -0.65). Platelet count did not significantly differ between groups or correlate with severity. CONCLUSION: Routine liver enzymes and hematological markers demonstrate significant diagnostic and prognostic value in evaluating liver lesions. Their integration into clinical workflows may enhance early detection, especially in resource-limited settings.