Abstract: To study the dependable of serum indexes estimating liver build up pathological changes degree in chronic hepatitis B. to evaluate the concordance between clinical diagnosis with pathological diagnosis in chronic hepatitis B. hepatic histological findings were diagnosed by liver inflammation grades (G) and fibrosis stages (S) . We examined the serum levels of ALT、AST、A/G、GGT、PTA、HBVDNA and compared clinical diagnosis with pathological diagnosis in 105 patients with chronic hepatitis B. serum ALT、AST、A/G、GGT、PTA Were significane difference in the each period of grades and stages (P<0.05) . HBVDNA were not difference in the each preiod of grades and stages in chronic hepatitis B (P>0.05) . accordance of the mild, medium and severe changes was 96.8%、50.0% and 7.7%. Serum ALT、AST、A/G、GGT、PTA may be used as the estimate indexes to organize pathological changes degree. but serum HBVDNA may not be used as the estimate indexes to organize pathological changes degree. The patients with clinical medium severe have to do pathological examination, possibly make the clinical diagnosis agree with pathology diagnosis.