Contemporary role of liver biopsy in hepatocellular carcinoma

Table 1 The incidence of needle-tract seeding after hepatocellular carcinoma biopsy

Ref.	Year	Lesion	Needle	No. of biopsies	No. of seeding	%
Yamashita et al[35]	1995	HCC	0.8-1.2 mm Bard	125	1	0.80
Huang et al[11]	1996	HCC	1.4-2 mm	455	9	2
Kanematsu et al[36]	1997	HCC	FNB 0.8 mm	50	2	4
Ch Yu et al[15]	1997	HCC	1.2 mm gun	139	0	0
Chapoutot et al[37]	1999	HCC	1.0-1.2 mm	150	4	2.66
Kim et al[28]	2000	HCC	1.1 mm gun	205	7	3.40
Takamori et al[27]	2000	HCC	FNB	59	3	5
Durand et al[14]	2001	HCC	1.2 mm	137	2	1.60
Kosugi et al[29]	2004	HCC	n.a	372	6	1.61
Ng et al[30]	2004	HCC	FNA	91	1	1.09
Shuto et al[31]	2004	HCC	n.a	480	5	1.04
Wang et al[32]	2005	HCC	FNA	90	0	0
Saborido et al[33]	2005	HCC	FNA	26	2	7.69
Maturen et al[25]	2006	HCC	1.2 mm, coaxial	128	0	0
Colecchia et al[34]	2012	HCC	0.95 mm	81	0	0
Total				2588	42	1.62

n.a: Not available; HCC: Hepatocellular carcinoma; %: Percent; FNA: Fine needle aspiration.

Table 2 Factors influencing the use of liver biopsy in hepatocellular carcinoma

1 Poor accuracy of contrast-enhanced methods in the diagnosis of HCC, especially in small lesions

2 The risks of LB, which are more severe in patients with cirrhosis and coagulopathy

3 Inadequate sampling of HCC lesions, especially in cases with very small or very large ones

4 The complex system of staging, treatment, and patient allocation to various therapy regimens (BCLC); the correct assessment of prognosis is important in the allocation of therapy, and is based mainly on pathology data

5 Modern therapies sometimes have limited applicability (transplantation), cost and effectiveness (systemic treatment); information resulting from histological analysis is necessary in order to increase effectiveness and personalize treatment

LB: Liver biopsy; HCC: Hepatocellular carcinoma; BCLC: Barcelona clinic liver cancer staging.