Assessment of the benefits and risks of percutaneous biopsy before surgical resection of hepatocellular carcinoma
Assessment of the benefits and risks of percutaneous biopsy before surgical resection of hepatocellular carcinoma
复制标题
DOI：
10.1016/s0168-8278(01)00108-8
复制
发表时间：
2001-08-01
影响因子：
25.7
通讯作者：
Valla, D
中科院分区：
文献类型：
--
作者：
Durand, F;Regimbeau, JM;Valla, D
背景/目的：由于针道播种的潜在风险，超声（US）引导下的肝细胞癌（HCC）活检诊断存在争议。本研究旨在确定该技术的有效性，准确性和安全性以及针道播种的发生率。方法：从1986年到1996年，137例因疑似HCC而行切除或移植的患者术前行us引导活检。将切除肝脏的分析结果与活检结果进行比较。患者接受平均38个月的随访。122例（89%）患者通过活检确诊HCC。15例活检呈阴性的患者中有13例术后发现HCC。其余2例为非恶性结节。超声引导下活检的敏感性为90%，准确性为91%。准确性受结节位置的显著影响，而不受其大小的影响。2例（1.6%）患者出现针道播种。结论：本组病例中，针束播散发生率小于2%，局部切除后无复发。这种风险应与在无恶性肿瘤的患者中决定积极治疗的风险相平衡。活检阴性的患者应进行第二次活检和/或通过成像技术重复检查。(C) 2001年欧洲肝脏研究协会。Elsevier Science B.V.版权所有。
Background/Aims: Because of a potential risk of needle tract seeding, the use of ultrasound (US)-guided biopsy for the diagnosis of hepatocellular carcinoma (HCC) is controversial. This study was aimed at determining the usefulness, accuracy and safety of this technique as well as the incidence of needle tract seeding.Methods: From 1986 to 1996, 137 patients who underwent resection or transplantation for suspected HCC had US-guided biopsy before surgery. The analysis of the resected liver was compared to the results of biopsy. Patients were assessed with a mean follow up of 38 months.Results. The diagnosis of HCC was established by biopsy in 122 patients (89%). Thirteen of the 15 patients with negative biopsy were shown to have HCC after surgery. The remaining two patients had non-malignant nodules. Sensitivity and accuracy of US-guided biopsy were 90 and 91%, respectively. Accuracy was significantly influenced by the location of the nodule but not by its size. Needle tract seeding occurred in two patients (1.6%).Conclusions: In this series, the incidence of needle tract seeding was less than 2% and no recurrence was observed after local excision. This risk should be balanced with the risk of deciding an aggressive treatment in a patient without malignancy. Patients with negative biopsy should undergo a second biopsy and/or repeated investigations by imaging techniques. (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.