Zheng Manna, Li Jiahao, Hu Chao, Tan Tianbao, Yang Jiliang, Pan Jing, Wu Huiying, Li Haibo, Lu Lianwei, Chen Xiwen, Zhang Xiaohong, Xu Tao, Zou Yan, Yang Tianyou
Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, 510623, China.
Pediatr Surg Int. 2020 Aug;36(8):909-915. doi: 10.1007/s00383-020-04702-3. Epub 2020 Jun 25.
BACKGROUND/PURPOSE: Hepatoblastoma diagnoses require liver biopsies. We aimed to investigate factors affecting the success of liver biopsy for hepatoblastoma diagnoses.
Data from patients with hepatoblastoma, including their demographic and clinical data, biopsy procedure information, pathologic diagnoses and subclassification, and surgical complications, were retrospectively reviewed.
Of 153 patients who underwent liver biopsy, 28, 93, and 31 underwent computed tomography-guided, digital subtraction angiography-guided, and ultrasound-guided percutaneous biopsies, respectively, and one underwent a laparoscopic liver biopsy. One patient developed postoperative bleeding requiring a blood transfusion. The median number of specimens collected was 3. One-hundred and forty-four (94.1%) patients' HB diagnoses were confirmed through biopsies, and 96 (62.7%) patients' HB diagnoses were subclassified. Seven surgeons and eight interventional radiologists performed the biopsies. The diagnostic success rate did not correlate with the biopsy technique or the specialist who performed the biopsy. Significantly more specimens were biopsied from the patients whose diagnoses were subclassified (3.34 ± 1.08) than from those whose diagnoses were not subclassified (2.81 ± 0.79). Surgeons tended to collect more specimens than the interventional radiologists.
Percutaneous liver biopsy is safe and effective for diagnosing hepatoblastoma, and its complication rate is very low. Collecting >3 pieces of tissue is preferred.
III.
背景/目的：肝母细胞瘤的诊断需要进行肝脏活检。我们旨在研究影响肝母细胞瘤诊断性肝脏活检成功率的因素。
回顾性分析肝母细胞瘤患者的数据，包括人口统计学和临床数据、活检操作信息、病理诊断及亚分类，以及手术并发症。
153例行肝脏活检的患者中，分别有28例、93例和31例接受了计算机断层扫描引导、数字减影血管造影引导和超声引导下的经皮活检，1例接受了腹腔镜肝脏活检。1例患者术后发生出血，需要输血。采集标本的中位数为3个。144例（94.1%）患者的肝母细胞瘤诊断通过活检得以确诊，96例（62.7%）患者的肝母细胞瘤诊断得以亚分类。7名外科医生和8名介入放射科医生进行了活检。诊断成功率与活检技术或进行活检的专科医生无关。诊断得以亚分类的患者（3.34±1.08）比未亚分类的患者（2.81±0.79）活检的标本明显更多。外科医生采集的标本往往比介入放射科医生多。
经皮肝脏活检对肝母细胞瘤的诊断安全有效，并发症发生率很低。最好采集>3块组织。
Ⅲ级。
