Reuters Health Information (2004-09-10): US-guided biopsy diagnoses early cancer in cirrhosis patients
US-guided biopsy diagnoses early cancer in cirrhosis patients
Last Updated: 2004-09-10 11:22:30 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Fine needle biopsy guided
by ultrasound is effective in identifying early hepatocellular
carcinoma in patients with cirrhotic livers, Italian researchers report
in the September issue of Gut.
"Ultrasound allows detection of very small focal liver lesions,"
lead investigator Dr. E. Caturelli, of Ospedale Belcolle, Vierbo, told
Reuters Health. "Most of such lesions, as easily proved by aimed
fine-needle biopsy, are neoplastic or preneoplastic, and they are
susceptible to prompt therapy."
Dr. Caturelli and colleagues analyzed data from 246 new nodular
lesions smaller than 20 mm, and 48 lesions smaller than 10 mm, which
were detected by ultrasound during screening in 4375 patients with
In 274 patients, alpha-fetoprotein (AFP) levels did not allow
diagnosis of liver cancer, and ultrasound-guided fine needle biopsy was
Altogether, 258 (87.6%) of lesions proved to be hepatocellular
carcinoma, which included 33 (68.7%) of the lesions smaller than or
equal to10 mm.
Typing accuracy for all lesions was 89.4%. For the smaller lesions, it was 88.6%.
In an accompanying editorial, Drs. J. Scholmerich and D. Schacherer
of the University of Regensburg, Germany note that the study "provides
long sought after and important information on the possible efficacy of
US guided biopsy of hepatocellular carcinoma in experienced hands and
will probably define the gold standard of quality of this procedure."
However, they add that it does answer the question of whether and in
whom biopsy should be performed. This, they say, "remains to some
extent a bedside decision."