Department of Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, USA.
Clin Transplant. 2013 Jul-Aug;27(4):E400-6. doi: 10.1111/ctr.12160. Epub 2013 Jul 10.
Although liver biopsy is a relatively safe procedure, needle tract seeding (NTS) of hepatocellular carcinoma (HCC) is described in up to 5% of patients after liver biopsy. The rate of NTS in patients with HCC who had liver transplantation is unknown. We performed a retrospective analysis of 759 HCC cases from August 1992 to August 2011. Demographics, ethnicities, risk factors, tumor characteristics, treatments, recurrence, and survival were collected. Patients who underwent percutaneous liver biopsy, resection, and transplant were identified. In all, 359 underwent biopsy to diagnose HCC and 42 patients underwent liver transplant. None of 171 patients who underwent radiofrequency ablation alone had seeding. None of the 11 patients who had biopsy and radiofrequency ablation performed in a single session developed NTS; however, two of 12 patients who had biopsy and radiofrequency ablation performed at separate sessions had NTS. Two patients underwent liver transplantation and subsequently developed needle tract seeding eventually died from HCC. Although the incidence of needle tract seeding was low in liver transplant patients, it can potentially change a curative therapy into a non-curative one. Single-session liver biopsy and radiofrequency ablation may reduce the risk of needle tract seeding of HCC.
虽然肝活检是一种相对安全的操作，但据报道，在肝活检后，多达 5%的肝细胞癌（HCC）患者会发生针道种植（NTS）。肝移植患者中 NTS 的发生率尚不清楚。我们对 1992 年 8 月至 2011 年 8 月期间的 759 例 HCC 病例进行了回顾性分析。收集了人口统计学、种族、危险因素、肿瘤特征、治疗、复发和生存情况。识别出接受经皮肝活检、切除术和移植的患者。共有 359 例患者接受肝活检以诊断 HCC，42 例患者接受肝移植。单独接受射频消融的 171 例患者无一例发生种植。在单次治疗中同时进行活检和射频消融的 12 例患者中，仅 2 例发生 NTS；然而，在分两次进行活检和射频消融的 12 例患者中，有 2 例发生 NTS。2 例患者接受肝移植后，随后发生针道种植，最终死于 HCC。尽管肝移植患者中 NTS 的发生率较低，但它可能会将根治性治疗变为非根治性治疗。单次肝活检和射频消融可能会降低 HCC 针道种植的风险。
