Skip to main content
Erschienen in:

26.01.2017 | Hepatic Cancer (A Singal and A Mufti, Section Editors)

Liver Biopsy for Hepatocellular Carcinoma (HCC): Should this be a Routine?

verfasst von: Adam Doyle, Morris Sherman

Erschienen in: Current Hepatology Reports | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

The diagnosis of hepatocellular carcinoma (HCC) in many cases can be made on the basis of imaging alone. There are validated algorithms that have high specificity for the diagnosis of HCC. In these cases, a biopsy is not necessary for diagnosis. However, many practitioners still advocate the use of a biopsy in order to accumulate tissue that can be used for research purposes. In today’s ethical climate, this practice would be considered unethical unless patient consent is obtained. To subject a patient to a potentially risky procedure for research purposes without obtaining informed consent is no longer permissible.
Literatur
1.
Zurück zum Zitat •• Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53(3):1020–2. This is the most recent North American guideline on the management of HCC indicating the role of biopsy.CrossRefPubMedPubMedCentral •• Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53(3):1020–2. This is the most recent North American guideline on the management of HCC indicating the role of biopsy.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat • Forner A, Vilana R, Ayuso C, Bianchi L, Solé M, Ayuso JR, et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology. 2008;47(1):97–104. This study provided validation of the recommendation about biopsy in the North American guidelines CrossRefPubMed • Forner A, Vilana R, Ayuso C, Bianchi L, Solé M, Ayuso JR, et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology. 2008;47(1):97–104. This study provided validation of the recommendation about biopsy in the North American guidelines CrossRefPubMed
3.
Zurück zum Zitat • Sangiovanni A, Manini MA, Iavarone M, Romeo R, Forzenigo LV, Fraquelli M, et al. The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis. Gut. 2010;59(5):638–44. This study provided validation of the recommendation about biopsy in the North American guidelines.CrossRefPubMed • Sangiovanni A, Manini MA, Iavarone M, Romeo R, Forzenigo LV, Fraquelli M, et al. The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis. Gut. 2010;59(5):638–44. This study provided validation of the recommendation about biopsy in the North American guidelines.CrossRefPubMed
4.
Zurück zum Zitat Bremner KE, Bayoumi AM, Sherman M, Krahn MD. Management of solitary 1 cm to 2 cm liver nodules in patients with compensated cirrhosis: a decision analysis. Can J Gastroenterol. 2007;21(8):491–500.CrossRefPubMedPubMedCentral Bremner KE, Bayoumi AM, Sherman M, Krahn MD. Management of solitary 1 cm to 2 cm liver nodules in patients with compensated cirrhosis: a decision analysis. Can J Gastroenterol. 2007;21(8):491–500.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat • Khalili K, Kim TK, Jang H-J, Haider MA, Khan L, Guindi M, et al. Optimization of imaging diagnosis of 1–2 cm hepatocellular carcinoma: an analysis of diagnostic performance and resource utilization. J Hepatol. 2011;54(4):723–8. The presence of distal radius malunion does not impact functional outcomes in elderly patients regardless of their activity level. • Khalili K, Kim TK, Jang H-J, Haider MA, Khan L, Guindi M, et al. Optimization of imaging diagnosis of 1–2 cm hepatocellular carcinoma: an analysis of diagnostic performance and resource utilization. J Hepatol. 2011;54(4):723–8. The presence of distal radius malunion does not impact functional outcomes in elderly patients regardless of their activity level.
6.
Zurück zum Zitat Sersté T, Barrau V, Ozenne V, Vullierme M-P, Bedossa P, Farges O, et al. Accuracy and disagreement of computed tomography and magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma and dysplastic nodules: Role of biopsy. Hepatology. 2012;55(3):800–6.CrossRefPubMed Sersté T, Barrau V, Ozenne V, Vullierme M-P, Bedossa P, Farges O, et al. Accuracy and disagreement of computed tomography and magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma and dysplastic nodules: Role of biopsy. Hepatology. 2012;55(3):800–6.CrossRefPubMed
7.
Zurück zum Zitat • Durand F, Regimbeau JM, Belghiti J, Sauvanet A, Vilgrain V, Terris B, et al. Assessment of the benefits and risks of percutaneous biopsy before surgical resection of hepatocellular carcinoma. J Hepatol. 2001;35(2):254–8. This study provided comprehensive data on the safety of biopsy for HCC.CrossRefPubMed • Durand F, Regimbeau JM, Belghiti J, Sauvanet A, Vilgrain V, Terris B, et al. Assessment of the benefits and risks of percutaneous biopsy before surgical resection of hepatocellular carcinoma. J Hepatol. 2001;35(2):254–8. This study provided comprehensive data on the safety of biopsy for HCC.CrossRefPubMed
8.
Zurück zum Zitat Caturelli E, Solmi L, Anti M, Fusilli S, Roselli P, Andriulli A, et al. Ultrasound guided fine needle biopsy of early hepatocellular carcinoma complicating liver cirrhosis: a multicentre study. Gut. 2004;53(9):1356–62.CrossRefPubMedPubMedCentral Caturelli E, Solmi L, Anti M, Fusilli S, Roselli P, Andriulli A, et al. Ultrasound guided fine needle biopsy of early hepatocellular carcinoma complicating liver cirrhosis: a multicentre study. Gut. 2004;53(9):1356–62.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat • International Consensus Group for Hepatocellular Neoplasia. Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia. Hepatology. 2009;49(2):658–64. An important paper on the diagnosis of very early HCC.CrossRef • International Consensus Group for Hepatocellular Neoplasia. Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia. Hepatology. 2009;49(2):658–64. An important paper on the diagnosis of very early HCC.CrossRef
10.
Zurück zum Zitat Stigliano R, Burroughs AK. Should we biopsy each liver mass suspicious for HCC before liver transplantation? - No, please don’t. J Hepatol. 2005;43(4):563–8.CrossRefPubMed Stigliano R, Burroughs AK. Should we biopsy each liver mass suspicious for HCC before liver transplantation? - No, please don’t. J Hepatol. 2005;43(4):563–8.CrossRefPubMed
11.
Zurück zum Zitat Roncalli M, Park YN, Di Tommaso L. Histopathological classification of hepatocellular carcinoma. Dig Liver Dis. 2010;42(S3):228–34.CrossRef Roncalli M, Park YN, Di Tommaso L. Histopathological classification of hepatocellular carcinoma. Dig Liver Dis. 2010;42(S3):228–34.CrossRef
12.
Zurück zum Zitat • Colecchia A, Scaioli E, Montrone L, Vestito A, Di Biase AR, Pieri M, et al. Pre-operative liver biopsy in cirrhotic patients with early hepatocellular carcinoma represents a safe and accurate diagnostic tool for tumour grading assessment. J Hepatol. 2011;54(2):300–5. Another paper on the safety of biopsy for HCC.CrossRefPubMed • Colecchia A, Scaioli E, Montrone L, Vestito A, Di Biase AR, Pieri M, et al. Pre-operative liver biopsy in cirrhotic patients with early hepatocellular carcinoma represents a safe and accurate diagnostic tool for tumour grading assessment. J Hepatol. 2011;54(2):300–5. Another paper on the safety of biopsy for HCC.CrossRefPubMed
13.
Zurück zum Zitat West J, Card TR. Reduced mortality rates following elective percutaneous liver biopsies. Gastroenterology. 2010;139(4):1230–7.CrossRefPubMed West J, Card TR. Reduced mortality rates following elective percutaneous liver biopsies. Gastroenterology. 2010;139(4):1230–7.CrossRefPubMed
14.
Zurück zum Zitat • Atwell TD, Smith RL, Hesley GK, Callstrom MR, Schleck CD, Harmsen WS, et al. Incidence •of bleeding after 15,181 percutaneous biopsies and the role of aspirin. Am J Roentgenol. 2010;194(3):784–9. Another paper on the safety of biopsy for HCC.CrossRef • Atwell TD, Smith RL, Hesley GK, Callstrom MR, Schleck CD, Harmsen WS, et al. Incidence •of bleeding after 15,181 percutaneous biopsies and the role of aspirin. Am J Roentgenol. 2010;194(3):784–9. Another paper on the safety of biopsy for HCC.CrossRef
15.
Zurück zum Zitat Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology. 2009;49(3):1017–44.CrossRefPubMed Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology. 2009;49(3):1017–44.CrossRefPubMed
16.
Zurück zum Zitat •• Silva MA, Hegab B, Hyde C, Guo B, Buckels JAC, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008;57(11):1592–6. Important paper on the risks of tumour seeding following a liver biopsy.CrossRefPubMed •• Silva MA, Hegab B, Hyde C, Guo B, Buckels JAC, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008;57(11):1592–6. Important paper on the risks of tumour seeding following a liver biopsy.CrossRefPubMed
17.
Zurück zum Zitat Stigliano R, Marelli L, Yu D, Davies N, Patch D, Burroughs AK. Seeding following percutaneous diagnostic and therapeutic approaches for hepatocellular carcinoma. What is the risk and the outcome? Seeding risk for percutaneous approach of HCC. Cancer Treat Rev. 2007;33(5):437–47.CrossRefPubMed Stigliano R, Marelli L, Yu D, Davies N, Patch D, Burroughs AK. Seeding following percutaneous diagnostic and therapeutic approaches for hepatocellular carcinoma. What is the risk and the outcome? Seeding risk for percutaneous approach of HCC. Cancer Treat Rev. 2007;33(5):437–47.CrossRefPubMed
18.
Zurück zum Zitat Wang P, Meng ZQ, Chen Z, Lin JH, Ping B, Wang LF, et al. Diagnostic value and complications of fine needle aspiration for primary liver cancer and its influence on the treatment outcome-a study based on 3011 patients in China. Eur J Surg Oncol. 2008;34(5):541–6.CrossRefPubMed Wang P, Meng ZQ, Chen Z, Lin JH, Ping B, Wang LF, et al. Diagnostic value and complications of fine needle aspiration for primary liver cancer and its influence on the treatment outcome-a study based on 3011 patients in China. Eur J Surg Oncol. 2008;34(5):541–6.CrossRefPubMed
19.
Zurück zum Zitat Maturen KE, Nghiem HV, Marrero JA, Hussain HK, Higgins EG, Fox GA, et al. Lack of tumor seeding of hepatocellular carcinoma after percutaneous needle biopsy using coaxial cutting needle technique. Am J Roentgenol. 2006;187(5):1184–7.CrossRef Maturen KE, Nghiem HV, Marrero JA, Hussain HK, Higgins EG, Fox GA, et al. Lack of tumor seeding of hepatocellular carcinoma after percutaneous needle biopsy using coaxial cutting needle technique. Am J Roentgenol. 2006;187(5):1184–7.CrossRef
20.
Zurück zum Zitat Shaw AT, Kim DW, Nakagawa K, Seto T, Crino L, Ahn MJ, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013;368(25):2385–94.CrossRefPubMed Shaw AT, Kim DW, Nakagawa K, Seto T, Crino L, Ahn MJ, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013;368(25):2385–94.CrossRefPubMed
21.
Zurück zum Zitat Van Cutsem E, Köhne CH, Hitre E, Zaluski J, Chang Chien C-R, Makhson A, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360(14):1408–17.CrossRefPubMed Van Cutsem E, Köhne CH, Hitre E, Zaluski J, Chang Chien C-R, Makhson A, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360(14):1408–17.CrossRefPubMed
22.
Zurück zum Zitat Giordano SH, Temin S, Kirshner JJ, Chandarlapaty S, Crews JR, Davidson NE, et al. Systemic therapy for patients with advanced human epidermal growth factor receptor 2-positive breast cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2014;32(19):2078–99.CrossRefPubMed Giordano SH, Temin S, Kirshner JJ, Chandarlapaty S, Crews JR, Davidson NE, et al. Systemic therapy for patients with advanced human epidermal growth factor receptor 2-positive breast cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2014;32(19):2078–99.CrossRefPubMed
23.
Zurück zum Zitat Iizuka N, Oka M, Yamada-Okabe H, Nishida M, Maeda Y, Mori N, et al. Oligonucleotide microarray for prediction of early intrahepatic recurrence of hepatocellular carcinoma after curative resection. Lancet. 2003;361(9361):923–9.CrossRefPubMed Iizuka N, Oka M, Yamada-Okabe H, Nishida M, Maeda Y, Mori N, et al. Oligonucleotide microarray for prediction of early intrahepatic recurrence of hepatocellular carcinoma after curative resection. Lancet. 2003;361(9361):923–9.CrossRefPubMed
24.
Zurück zum Zitat Ye Q-H, Qin L-X, Forgues M, He P, Kim JW, Peng AC, et al. Predicting hepatitis B virus-positive metastatic hepatocellular carcinomas using gene expression profiling and supervised machine learning. Nat Med. 2003;9(4):416–23.CrossRefPubMed Ye Q-H, Qin L-X, Forgues M, He P, Kim JW, Peng AC, et al. Predicting hepatitis B virus-positive metastatic hepatocellular carcinomas using gene expression profiling and supervised machine learning. Nat Med. 2003;9(4):416–23.CrossRefPubMed
25.
Zurück zum Zitat Lee JS, Chu IS, Heo J, Calvisi DF, Sun Z, Roskams T, et al. Classification and prediction of survival in hepatocellular carcinoma by gene expression profiling. Hepatology. 2004;40(3):667–76.CrossRefPubMed Lee JS, Chu IS, Heo J, Calvisi DF, Sun Z, Roskams T, et al. Classification and prediction of survival in hepatocellular carcinoma by gene expression profiling. Hepatology. 2004;40(3):667–76.CrossRefPubMed
26.
Zurück zum Zitat Villanueva A, Hoshida Y, Battiston C, Tovar V, Sia D, Alsinet C, et al. Combining clinical, pathology, and gene expression data to predict recurrence of hepatocellular carcinoma. Gastroenterology. 2011;140(5):1501–12.CrossRefPubMedPubMedCentral Villanueva A, Hoshida Y, Battiston C, Tovar V, Sia D, Alsinet C, et al. Combining clinical, pathology, and gene expression data to predict recurrence of hepatocellular carcinoma. Gastroenterology. 2011;140(5):1501–12.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Nault J, De Reyniès A, Villanueva A, Calderaro J, Rebouissou S, Couchy G, et al. A hepatocellular carcinoma 5-gene score associated with survival of patients after liver resection. Gastroenterology. 2013;145(1):176–87.CrossRefPubMed Nault J, De Reyniès A, Villanueva A, Calderaro J, Rebouissou S, Couchy G, et al. A hepatocellular carcinoma 5-gene score associated with survival of patients after liver resection. Gastroenterology. 2013;145(1):176–87.CrossRefPubMed
28.
Zurück zum Zitat Chan SL, Wong AM, Lee K, Wong N, Chan AKC. Personalized therapy for hepatocellular carcinoma: where are we now? Cancer Treat Rev. 2016;45:77–86.CrossRefPubMed Chan SL, Wong AM, Lee K, Wong N, Chan AKC. Personalized therapy for hepatocellular carcinoma: where are we now? Cancer Treat Rev. 2016;45:77–86.CrossRefPubMed
29.
30.
Zurück zum Zitat Friemel J, Rechsteiner M, Frick L, Böhm F, Struckmann K, Egger M, et al. Intratumor heterogeneity in hepatocellular carcinoma. Clin Cancer Res. 2015;21(8):1951–61.CrossRefPubMed Friemel J, Rechsteiner M, Frick L, Böhm F, Struckmann K, Egger M, et al. Intratumor heterogeneity in hepatocellular carcinoma. Clin Cancer Res. 2015;21(8):1951–61.CrossRefPubMed
31.
Zurück zum Zitat • Torbenson M, Schirmacher P. Liver cancer biopsy--back to the future?! Hepatology. 2015;61(2):431–3. The argument in favour of biopsy of all HCC's is presented in this paper.CrossRefPubMed • Torbenson M, Schirmacher P. Liver cancer biopsy--back to the future?! Hepatology. 2015;61(2):431–3. The argument in favour of biopsy of all HCC's is presented in this paper.CrossRefPubMed
Metadaten
Titel
Liver Biopsy for Hepatocellular Carcinoma (HCC): Should this be a Routine?
verfasst von
Adam Doyle
Morris Sherman
Publikationsdatum
26.01.2017
Verlag
Springer US
Erschienen in
Current Hepatology Reports / Ausgabe 1/2017
Elektronische ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-017-0333-2

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Innere Medizin

Studie zur HIFU bei Prostatakrebs lässt viele Fragen offen

Führt eine HIFU-Ablation beim Prostatakarzinom im Vergleich mit einer radikalen Prostatektomie zu ähnlichen onkologischen, aber besseren funktionalen Ergebnissen? Interimsdaten der französischen HIFI-Studie sind uneindeutig. In einem Kommentar zur Studie werden zumindest drei allgemeine Erkenntnisse herausgearbeitet.

Leitlinienkonformes Management thermischer Verletzungen

Thermische Verletzungen gehören zu den schwerwiegendsten Traumen und hinterlassen oft langfristige körperliche und psychische Spuren. Die aktuelle S2k-Leitlinie „Behandlung thermischer Verletzungen im Kindesalter (Verbrennung, Verbrühung)“ bietet eine strukturierte Übersicht über das empfohlene Vorgehen.

Frühe Hyperoxie nach Reanimation schlecht für die Prognose?

Kommt es sehr früh nach einer kardiopulmonalen Reanimation zu einem Zustand der Hyperoxie, ist dies bei Patientinnen und Patienten nach einem Herzstillstand mit schlechteren funktionellen Ergebnissen assoziiert. Das zeigt eine Sekundäranalyse der TTM-2-Studie.

Infektanfälligkeit in früher Kindheit: eine bleibende Last?

Wenn Kinder in den ersten Lebensjahren immer wieder Infekte durchmachen, lässt dies Schlüsse auf die Infektneigung in der weiteren Kindheit zu.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.