Chen Xiao, Kutaiba Numan, Ngo Brian, Goodwin Mark
Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia.
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2019 Apr;63(2):190-196. doi: 10.1111/1754-9485.12856. Epub 2019 Jan 16.
To evaluate the histopathological and safety outcomes of indeterminate lesions in patients at high risk for developing hepatocellular carcinoma (HCC) who underwent ultrasound-guided biopsies.
Ultrasound-guided targeted liver biopsies for indeterminate lesions performed in a 10-year period at our institution were reviewed retrospectively for lesion characteristics, biopsy techniques, histopathological results and post procedural complications.
A total of 172 biopsies were performed in 152 patients. Most common background liver disease included hepatitis C, hepatitis B, alcoholic and non-alcoholic steatohepatitis. 65.1% had known cirrhosis at time of biopsy. HCC was the most common histopathological finding accounting for 55.8% of all biopsies, followed by cholangiocarcinoma, dysplastic nodule and metastasis. Rarer lesions including lymphoma, neuroendocrine tumour and angiomyolipoma were also encountered. No mortality, clinically significant bleeding or tumour seeding was detected.
Ultrasound-guided liver biopsies of indeterminate lesions in patients at high risk of HCC yield important histopathological findings, important for management options including the provision of curative treatments and assisting future novel therapies such as immunotherapy and targeted therapies. The low complication rates confirm its safety and the procedure should not be avoided for fear of complications.
评估接受超声引导下活检的肝细胞癌（HCC）高危患者中不确定病变的组织病理学和安全性结果。
回顾性分析我们机构在10年期间对不确定病变进行的超声引导下靶向肝活检的病变特征、活检技术、组织病理学结果和术后并发症。
共对152例患者进行了172次活检。最常见的背景肝病包括丙型肝炎、乙型肝炎、酒精性和非酒精性脂肪性肝炎。65.1%的患者在活检时已知患有肝硬化。HCC是最常见的组织病理学发现，占所有活检的55.8%，其次是胆管癌、发育异常结节和转移瘤。还发现了罕见病变，包括淋巴瘤、神经内分泌肿瘤和血管平滑肌脂肪瘤。未检测到死亡、具有临床意义的出血或肿瘤种植。
对HCC高危患者的不确定病变进行超声引导下肝活检可得出重要的组织病理学结果，这对管理方案很重要，包括提供根治性治疗以及辅助未来的新型疗法，如免疫疗法和靶向疗法。低并发症发生率证实了其安全性，不应因担心并发症而避免该操作。
