Yamashita Y, Matsukawa T, Arakawa A, Hatanaka Y, Urata J, Takahashi M
Department of Radiology, Kumamoto University School of Medicine, Japan.
Radiology. 1995 Sep;196(3):799-804. doi: 10.1148/radiology.196.3.7644646.
To analyze the results of ultrasound (US)-guided biopsy as a predictor of the outcome of interventional treatment of hepatocellular carcinoma (HCC).
US-guided biopsy was performed in 125 lesions in 102 high-risk patients, before transcatheter arterial embolization (TAE) (82 lesions) or before percutaneous ethanol injection (PEI) therapy (25 lesions, including 14 lesions previously treated with TAE). Pathologic results were correlated with treatment effects.
Results of biopsy confirmed 107 HCCs, which were classified as early (n = 17), frank (n = 67), sclerosing (n = 12), or poorly differentiated or undifferentiated (n = 11). Hypervascularity was observed in most frank HCCs, with a good response to TAE. Tumor vascularity in early or sclerosing HCCs was slight and did not respond to TAE. Sclerosing and poorly differentiated or undifferentiated HCCs enlarged after treatment, whereas early HCCs did not. Early HCCs were treated successfully with PEI therapy; sclerosing HCCs responded poorly to PEI therapy.
Evaluation of histologic subtype of HCC by means of US-guided biopsy is essential, because subtype may affect treatment planning.
分析超声（US）引导下活检作为肝细胞癌（HCC）介入治疗结果预测指标的情况。
对102例高危患者的125个病灶进行US引导下活检，其中82个病灶在经导管动脉栓塞术（TAE）前进行活检，25个病灶（包括14个先前接受过TAE治疗的病灶）在经皮乙醇注射（PEI）治疗前进行活检。将病理结果与治疗效果进行关联分析。
活检结果证实107例为HCC，分为早期（n = 17）、典型（n = 67）、硬化型（n = 12）或低分化或未分化型（n = 11）。大多数典型HCC表现为血管丰富，对TAE反应良好。早期或硬化型HCC的肿瘤血管较少，对TAE无反应。硬化型和低分化或未分化型HCC在治疗后增大，而早期HCC未增大。早期HCC通过PEI治疗成功；硬化型HCC对PEI治疗反应不佳。
通过US引导下活检评估HCC的组织学亚型至关重要，因为亚型可能影响治疗方案的制定。
