The Need for Liver Puncture Biopsy
In primary hepatocellular carcinoma, imaging has important value in screening, diagnosis, differential diagnosis, guiding treatment decisions, and efficacy evaluation, according to the Primary Liver Cancer Diagnostic and Treatment Protocol (2017 Edition):
“Patients with occupying lesions with typical hepatocellular carcinoma imaging features that meet the clinical diagnostic criteria for hepatocellular carcinoma usually do not require liver puncture biopsy for diagnostic purposes.”
Therefore, liver aspiration biopsy for diagnostic purposes is not recommended at this time.
However, the biological behavior of hepatocellular carcinoma is the most important pathological factor affecting the outcome and survival of patients with hepatocellular carcinoma, and the currently popular targeted therapies require genetic testing of the tumor, and in these cases, a puncture biopsy of the tumor is necessary.
As for other rare types of primary hepatocellular carcinoma, as well as liver metastatic lesions from a variety of systemic malignancies, liver aspiration biopsy is necessary for a definitive diagnosis.
No need to worry about tumor rupture or spread due to liver puncture
A liver tumor puncture biopsy is performed with a biopsy needle guided by ultrasound or CT through the skin abdominal wall of the liver and through the tumor envelope to access the tumor tissue. This is why some patients are concerned about tumor rupture or dissemination.
The physician will make a thorough assessment of the patient’s general condition, including tumor location, size, and coagulation, before the puncture; then select the appropriate puncture route and puncture needle based on the imaging data, and use skilled puncture positioning techniques to minimize repeated punctures, avoid tumor rupture, and obtain appropriate and sufficient tumor tissue for pathologic analysis and diagnosis.
Physicians also perform liver puncture with postoperative compression and vital signs to ensure patient safety.
Therefore, in patients who meet the indications for puncture, tumor rupture or spread is still quite rare, and patients and their families need not worry too much, after all, it is of utmost importance to determine the nature of the tumor as early as possible and take appropriate treatment.