| 원저 / 간세포암 진단을 위한 세침흡인 세포학적 검사의 필요성과 안전성 ( Necessity and Safety of Fine-needle Aspiration Cytology for Diagnosis of Hepatocellular Carcinoma ) |
|
|
| Necessity and Safety of Fine-needle Aspiration Cytology for Diagnosis of Hepatocellular Carcinoma |
| Jin Ok Lee, Sung Jae Yoo, Sung Moon Jung, Yong Whan Song, Sook-Hyang Jung, Chul Ju Han
You Cheoul Kim, Chang-Min Kim, Jhin Oh Lee, Byung Hee Lee1 , Kie Hwan Kim1
Kyung Ja Cho3 and Seung-Sook Lee2 |
| Department of Internal Medicine, Diagnostic Radiology1 & Anatomic Pathology2 Korea Cancer Center Hospita2, Seoul, Korea
Department of Anatomic Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea3 |
|
|
|
|
| ABSTRACT |
|
Backgrounds
/Aims: The fine-needle aspiration (FNA) is a useful method for diagnosis of hepatocellular carcinoma (HCC). The aims of our study are to assess diagnostic accuracy of FNA, to define proper indications of FNA for diagnosis of HCC, and to evaluate the complications of FNA. Subjects and Methods: To assess diagnostic accuracy we compared the results of preoperative FNA with postoperative pathology in 38 resected cases with primary liver cancer. To define proper indications and complications of FNA, we prospectively followed 138 patients received FNA for their liver tumors which were suspicious of primary liver tumor. Results : The sensitivity, specificity, positive and negative predictive values of FNA were 100%, 97%, 100% and 66% respectively. All patients with serum alpha-fetoprotein (AFP) level over 1000 ng/ml were having HCC on FNA result. Among 36 patients with AFP level ranged 15-1000 ng/ml and hypervascular mass on angiography, 96% were having HCC. Among 50 patients with normal AFP level and hypervascular mass on angiography, 92% were having HCC. The major complications after FNA such as hemoperitoneum, pneumothorax, and iatrogenic arterioportal shunt developed in 2%, 2%, and 7% of subjects, respectively. We did not find any case of needle-tract seeding of cancer during a mean 4.7 months of follow-up. Conclusions: Although the FNA is an accurate method for diagnosis of HCC, FNA was usually not indicated for patients with serum AFP level over 1000 ng/ml or patients with hypervascular mass on angiography when they were suspected of having primary liver cancer. Major complications were hemoperitoneum, pneumothorax and iatrogenic arterioportal shunt. Iatrogenic arterioportal shunt may influence the efficacy of subsequent transcatheter arterial embolization. |
| KeyWords:
Newoplasm/Liver/Hepatocellular carcinoma, Fine- needle aspiration |
|
|
PDF Links
Full text via DOI
Download Citation
