title: 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.
abstract: OBJECTIVE
  To determine the diagnostic value and major complications of fine-needle aspiration (FNA) for primary liver cancer (PLC) and its influence on the treatment outcome and prognosis.
  
  
  METHODS
  Information was gathered retrospectively for 3011 patients who presented with suspected PLC. Of which 2528 cases underwent ultrasound-guided fine-needle aspiration (US-FNA) biopsy. Patients were followed up through repeated office visits and imaging studies with a median follow-up of 7 months (range, 1-29 months).
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of cytological diagnosis by FNA biopsy for detection of liver malignancy were 91.5%, 100.0%, 100.00%, 59.1% and 92.4% respectively. All patients with AFP> or = 400 microg/L were associated with malignancy. Of 1154 patients with AFP<400 microg/L who were finally proved PLC, 945 were detected by FNA alone. Major complications included bleeding in 11 cases (5 of them died later), occurred mainly in hepatocellular carcinoma with superficial location, large tumors and severe cirrhosis, and implantation metastases in 5 cases, which were recognized as a subcutaneous nodule at the previous biopsy site. Implantation metastases were treated with resection or radiotherapy.
  
  
  CONCLUSIONS
  FNA biopsy is valuable for the diagnosis of PLC. However, complications of post-biopsy hemorrhage should not be ignored, as such bleeding may be fatal. Implantation seems to have little effect on the prognosis.
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, Cancer Hospital, Fudan University, Shanghai, China.
authors.forename: P
authors.initials: P
authors.lastname: Wang
authors.forename: Z Q
authors.initials: ZQ
authors.lastname: Meng
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.forename: J H
authors.initials: JH
authors.lastname: Lin
authors.forename: B
authors.initials: B
authors.lastname: Ping
authors.forename: L F
authors.initials: LF
authors.lastname: Wang
authors.forename: B H
authors.initials: BH
authors.lastname: Wang
authors.forename: L M
authors.initials: LM
authors.lastname: Liu
mesh_terms: D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology*; D002681:China; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology* / Q000628:therapy; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins