Diagnostic accuracy of fine-needle aspiration biopsy in patients with hepatocellular carcinoma

• Published in: Digestive diseases and sciences 1989-11, Vol.34 (11), p.1765-1769
• Main Authors: BRU, C, MAROTO, A, BRUIX, J, FAUS, R, BIANCHI, L, CALVET, X, AYUSO, C, VILANA, R, GILABERT, R, RODES, J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biopsy, Needle - methods; Carcinoma, Hepatocellular - pathology; Evaluation Studies as Topic; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver Neoplasms - pathology; Liver Neoplasms - ultrastructure; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Tumors
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/BF01540056

The present study was undertaken to investigate the diagnostic usefulness of fine-needle aspiration biopsy (FNAB) in a large series of patients with hepatocellular carcinoma (HCC) seen over a 1-year period. During 1986, ultrasonographically guided percutaneous FNAB was performed in 72 patients with suspected HCC. A final diagnosis of HCC was made in 58 patients. The presence or absence of HCC was ascertained by histological examination and/or by other diagnostic procedures (alpha 1-fetoprotein, computed tomography, arteriography) and by clinical follow-up (repeated ultrasonographic controls) and/or by surgery or necropsy. A total of 61 FNABs were carried out in these 58 patients. Only 42 (69%) of the 61 FNABs allowed the diagnosis of HCC. This moderate diagnostic sensitivity was not related to tumor size. Only one false positive result was observed in the non-HCC group. Therefore, the diagnostic specificity of FNAB for HCC was 93%, with a positive predictive value of 97% and a negative predictive value of 40%. These results show that FNAB is a useful diagnostic technique in patients with HCC. However, these data also show that there is a large proportion (31%) of subjects with false negative results. Therefore, we suggest that further efforts should be made to improve the diagnostic accuracy of this procedure.