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Histology obtained by needle biopsy gives additional information on the prognosis of hepatocellular carcinoma.
MedLine Citation:
PMID:  22548688     Owner:  NLM     Status:  PubMed-not-MEDLINE    
AIM:   Hepatocellular carcinomas (HCC) have a strong biological heterogeneity. Current prognostic scores do not include histology. Information on the behavior of HCC based on histology has been characterized on retrospective data and large tissue specimens. We aimed to assess the additional value of needle biopsy and keratin 19 (K19) assessment in a prospective manner.
METHODS:   Between 2003 and 2008, all patients with a confirmed diagnosis of HCC by a percutaneous or laparoscopic needle biopsy at the time of diagnosis, and of Barcelona Clinic Liver Cancer (BCLC) stage A, B or C, were included. The exclusion criterion was a palliative setting. Biopsies were scored for microvascular invasion, differentiation, K19, epithelial cell adhesion molecule and α-fetoprotein staining. Clinical and radiological features were registered at time of biopsy. The added value of K19 was assessed using Cox proportional hazards regression.
RESULTS:   Of 74 patients screened, we included 58 patients. Based on the BCLC, 41% presented with early disease (BCLC A), 16% with intermediate disease (BCLC B) and 43% with advanced disease (BCLC C). In nine patients (16%), K19 staining was positive. Median follow up was 54 months (range 1-74) and 43 patients (72%) died. BCLC classification predicted the prognosis accurately, but histology offered additional prognostic information. In multivariate analysis, K19 was a strong predictor of overall survival (hazard ratio 4.57, 95% confidence interval 1.86-10.6), which improved predictive performance. No needle tract dissemination was observed.
CONCLUSION:   Despite the possible problem of sampling error, needle biopsy offered additional prognostic information. This is especially the case for K19 staining.
Hannah van Malenstein; Mina Komuta; Chris Verslype; Vincent Vandecaveye; Ben Van Calster; Baki Topal; Wim Laleman; David Cassiman; Werner Van Steenbergen; Raymond Aerts; Dirk Vanbeckevoort; Didier Bielen; Jacques Pirenne; Jos van Pelt; Tania Roskams; Frederik Nevens
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Publication Detail:
Type:  Journal Article     Date:  2012-04-30
Journal Detail:
Title:  Hepatology research : the official journal of the Japan Society of Hepatology     Volume:  42     ISSN:  1386-6346     ISO Abbreviation:  Hepatol. Res.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-24     Completed Date:  2013-07-04     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  9711801     Medline TA:  Hepatol Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  990-8     Citation Subset:  -    
Copyright Information:
© 2012 The Japan Society of Hepatology.
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