Diagnostic Value of Preoperative Needle Biopsy for Tumor Grading Assessment in Hepatocellular Carcinoma

PLoS One. 2015 Dec 14;10(12):e0144216. doi: 10.1371/journal.pone.0144216. eCollection 2015.

Abstract

Background: Needle core biopsy (NCB) is one of the most widely used and accepted methods for the diagnosis of focal hepatic lesions. Although many studies have assessed the diagnostic accuracy of NCB in predicting the tumor grade, it is still under debate.

Objective: To identify the influence of number of biopsies on NCB diagnostic accuracy.

Methods: 153 patients with HCC were selected from patients who received preoperative NCB under the guidance of ultrasonography in our hospital. The diagnostic reference standard was the surgical pathologic diagnosis.

Results: Using a 3-tier grading scheme (well, moderate and poor), the accuracy of NCB has no significant differences among different number of passes in HCC ≤5 cm. For HCC >5≤8 cm, the increasing number of passes could increase the diagnostic accuracy (63.3%, 81.8%, and 84.8% for passes one, two, and three, respectively). While in HCC>8 cm, the diagnostic accuracy of passes one, two, and three were 62.1%, 69%, and 75.8%, respectively.

Conclusions: The accuracy of NCB in assessing tumor grading associated with tumor size and number of passes. Meanwhile, a minimum of two passes should be performed to get better accuracy in patients with HCC >5 cm.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Large-Core Needle / standards*
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery
  • Female
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Predictive Value of Tests

Grants and funding

This study was supported by the National High-tech R&D Program of China (863 Program) (No.2012AA020204), National science and technology major projects (No. 2012ZX10002010-001-005), Zhejiang Provincial Program for the Cultivation of High-level Innovative Health talents, Chang Jiang Scholars Program and “Program for New Century Excellent Talents in University” of the Ministry of Education of China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.