Does percutaneous liver biopsy of hepatocellular carcinoma cause hematogenous dissemination? An in vivo study with quantitative assay of circulating tumor DNA using methylation-specific real-time polymerase chain reaction.
OBJECTIVE
Our purpose was to find out whether percutaneous biopsy of hepatocellular carcinoma will cause significant dissemination of tumor into the circulation by quantitative analysis of circulating tumor DNA.


METHODS
In this prospective study of 32 patients with suspected hepatocellular carcinoma who underwent sonographically guided liver biopsy, a peripheral venous blood sample was obtained before and 5 min after the procedure. Biopsy was performed using an 18-gauge biopsy gun. DNA was extracted from the plasma of the blood samples for methylation-specific polymerase chain reaction. Quantitative measures of the plasma tumor DNA were determined with real-time quantitative polymerase chain reaction, and the amount was expressed as a methylation index (%) in plasma.


RESULTS
Nineteen (59.4%) of 32 patients did not have detectable p16 tumor suppressor gene marker (p16M) in plasma before biopsy, and they showed no detectable plasma p16M after biopsy. Thirteen (65%) of 20 patients had p16M identified in the plasma before liver biopsy. Quantitative analysis of the plasma tumor DNA in these 13 patients showed no statistically significant difference in the methylation index before and after biopsy (p = 0.345, Wilcoxon's signed rank test).


CONCLUSIONS
No evidence exists that percutaneous liver biopsy results in hematogenous dissemination of hepatocellular carcinoma as shown by quantitative analysis of circulating tumor DNA (p16M) using methylation-specific real-time polymerase chain reaction.
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, 30-32 Ngan Shing St., Shatin, New Territories, Hong Kong SAR. simonyu@cuhk.edu.hk
Simon Chun Ho
SC
Yu
Dennis Yuk Ming
DY
Lo
Chei Bing
CB
Ip
Choong Tsek
CT
Liew
Thomas Wai Tong
TW
Leung
Wan Yee
WY
Lau
D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D019175:DNA Methylation; D004273:DNA, Neoplasm / Q000097:blood*; D019942:Genes, p16; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D018084:Ultrasonography, Interventional
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm