Application of ultrasound-guided liver puncture biopsy followed by coaxial biopsy needle tract radiofrequency ablation in patients with hepatocellular carcinoma at risk of bleeding
10.3760/cma.j.cn113884-20250118-00019
- VernacularTitle:超声引导下经皮肝穿刺活检后行同轴活检针道射频消融在有出血风险肝细胞癌患者中的应用分析
- Author:
Sitong WU
1
;
Hao CHENG
;
Siyuan FAN
;
Yong XIE
;
Zechuan LIU
;
Tianshi LYU
;
Li SONG
;
Xiaoqiang TONG
;
Yinghua ZOU
;
Hong ZHAO
;
Jian WANG
Author Information
1. 北京大学第一医院介入血管外科，北京 100034
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Biopsy, needle;
Radiofrequency ablation;
Hemorrhage
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(7):515-518
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyse the effect of ultrasound-guided percutaneous liver biopsy and the coaxial biopsy needle tract radiofrequency ablation on patients diagnosed with hepatocellular carcinoma who are considered to be at risk of bleeding.Methods:The data of 117 patients with hepatocellular carcinoma who underwent coaxial biopsy needle tract radiofrequency ablation after ultrasound-guided percutaneous liver biopsy in Peking University First Hospital from March 2019 to April 2023 were retrospectively analysed. There were 95 males and 22 females, with the age of (62.0±11.8) years. A comprehensive analysis was conducted on the following variables: the pre-puncture platelet count, the international standardised ratio, anticoagulation therapy, the haemoglobin (Hb) level, the success rate of the liver puncture, the qualified rate of liver puncture specimens, the number of puncture samples, the length of hospital stay, the Hb level after puncture, bleeding within 10 days post-operation, and complications after ablation, including biliary fistula, hemothorax and organ perforation.Results:Among the 117 patients, 60 cases (51.3%) had an international normalized ratio >1.1, 40 cases (34.2%) had thrombocytopenia, that is, <150×10 9/L, and 17 cases (14.5%) received continuous anticoagulation therapy before the operation. It is evident that all 117 patients successfully completed the ultrasound-guided percutaneous liver biopsy, and that all liver biopsy specimens were qualified. The absence of biliary fistula, hemothorax, organ perforation or death in the patients post-ablation was noted. According to the adverse event evaluation criteria, version 5.0, 113 cases (96.6%) were classified as grade 1 and 4 cases (3.4%) were classified as grade 3. The Hb concentration of patients with minor bleeding (grade 1) prior to puncture was (119.7±22.2) g/L, which was significantly higher than the Hb concentration of patients with severe bleeding (grade 3), (76.0±10.4) g/L ( t=3.92, P=0.010). A meticulous examination of the data revealed that there were no statistically significant differences between the two groups with regard to pre-puncture platelet count, pre-puncture international standardised ratio, pre-puncture proportion of receiving anticoagulant drugs, length of hospital stay and number of puncture samples (all P>0.05). Conclusion:For patients with hepatocellular carcinoma who are at risk of bleeding, ultrasound-guided percutaneous liver biopsy followed by coaxial biopsy needle tract radiofrequency ablation can obtain satisfactory liver tissue samples and is relatively safe. There were differences in hemoglobin levels before puncture among patients with different bleeding after puncture.
