Basingstoke Hepatobiliary Unit, Basingstoke and North Hampshire Hospitals NHS Foundation Trust Basingstoke, UK.
HPB (Oxford). 2009 Nov;11(7):533-40. doi: 10.1111/j.1477-2574.2009.00081.x.
Despite a growing body of evidence reporting the deleterious mechanical and oncological complications of biopsy of hepatic malignancy, a small but significant number of patients undergo the procedure prior to specialist surgical referral. Biopsy has been shown to result in poorer longterm survival following resection and advances in modern imaging modalities provide equivalent, or better, diagnostic accuracy.
The literature relating to needle-tract seeding of primary and secondary liver cancers was reviewed. MEDLINE, EMBASE and the Cochrane Library were searched for case reports and series relating to the oncological complications of biopsy of liver malignancies. Current non-invasive diagnostic modalities are reviewed and their diagnostic accuracy presented.
Biopsy of malignant liver lesions has been shown to result in poorer longterm survival following resection and does not confer any diagnostic advantage over a combination of non-invasive imaging techniques and serum tumour markers.
Given that chemotherapeutic advances now often permit downstaging and subsequent resection of 'unresectable' disease, the time has come to abandon biopsy of solid lesions outside the setting of a specialist multi-disciplinary team meeting (MDT).
尽管越来越多的证据表明活检肝脏恶性肿瘤会带来有害的机械和肿瘤学并发症，但仍有一小部分患者在接受专科手术转诊前进行了该操作。活检会导致切除术后的长期生存率降低，而现代影像学手段的进步可提供等效或更好的诊断准确性。
我们回顾了与原发性和继发性肝癌经皮肝穿刺活检针道种植转移相关的文献。我们检索了 MEDLINE、EMBASE 和 Cochrane 图书馆中关于肝癌活检的肿瘤学并发症的病例报告和系列研究。本文还回顾了当前的非侵入性诊断方法，并介绍了它们的诊断准确性。
研究表明，与非侵入性成像技术和血清肿瘤标志物相结合相比，活检恶性肝病变会导致切除术后的长期生存率降低，且不会带来任何诊断优势。
鉴于化疗的进步现在通常允许对“不可切除”疾病进行降期，随后进行切除，因此，现在是时候放弃在多学科团队会议（MDT）之外对实体病变进行活检了。
