Br J Cancer:晚期肝细胞癌患者诊断性活检的可行性分析

2021-10-13 xiaozeng MedSci原创

早在2001年欧洲肝脏研究协会(EASL)首次定义了用于诊断肝细胞癌(HCC)的无创放射学标准(NIRC),并随着时间的推移不断的完善该标准。

早在2001年欧洲肝脏研究协会(EASL)首次定义了用于诊断肝细胞癌(HCC)的无创放射学标准(NIRC),并随着时间的推移不断的完善该标准。目前大多数调查NIRC诊断准确性的研究都是回顾性研究,重点是针对早期疾病的检测。尽管如此,该诊断标准已经扩展到晚期疾病,然而,关于影像学诊断准确性和晚期疾病患者活检相关并发症发生率的数据结果仍非常有限。

2017 年11月,英国NHS要求在开始使用药物索拉非尼(sorafenib)进行治疗之前对HCC进行组织学的确认。同时也允许进行多中心、前瞻性的审核,以更好的鉴定晚期HCC患者活检的安全性和结果。


该研究是一项前瞻性多中心的审核研究,并在多学科会议上确定了适合索拉非尼治疗的患者。研究人员收集了相关的临床、放射学和组织学数据并汇总至标准化病例报告表中。

结果显示,研究人员共收集了11个中心的418例病例,其中的361例为主要分析队列(PAC)。总体而言,76%的患者患有慢性肝病,66%的患者患有肝硬化。而上述71%的患者的诊断方式为计算机断层扫描成像,27%的患者采用磁共振成像,而剩余的2%两者均有。


45名患者已有组织学检查数据,270名患者接受了新的活检,其中93.4%的患者确诊了HCC。其他组织学诊断结果包括胆管癌(CC)以及HCC-CC。进一步的研究结果显示,在肝硬化患者中,NIRC标准检测HCC的敏感性为65.4%,阳性预测率为91.4%。在检测过程中有两名患者(0.7%)经历了轻微的活检后出血。

研究流程图

总而言之,该研究结果揭示,对于大多数符合全身治疗条件的患者,诊断性活检是安全可行的。


原始出处:

Childs, A., Zakeri, N., Ma, Y.T. et al. Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit. Br J Cancer (15 September 2021).

 

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    2022-06-10 ms6000001791212108

    学习了

    0

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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Wed Oct 13 06:44:22 CST 2021, time=2021-10-13, status=1, ipAttribution=)]
    2022-09-25 swallow
  5. 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topicId=null, topicList=[TopicDto(id=59863, encryptionId=a92e59863f2, topicName=晚期肝细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Oct 14 15:07:49 CST 2021, time=2021-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060021, encodeId=485f106002185, content=彩超或者CT引导下, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ece61961273, createdName=雲深無迹, createdTime=Wed Oct 13 07:25:31 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060002, encodeId=0e1a106000249, content=小日本货忍具喔垮塌下来, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Wed Oct 13 06:44:22 CST 2021, time=2021-10-13, status=1, ipAttribution=)]
    2021-11-19 ms4000001809038213

    学习了,谢谢分享

    0

  6. 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topicId=null, topicList=[TopicDto(id=59863, encryptionId=a92e59863f2, topicName=晚期肝细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Oct 14 15:07:49 CST 2021, time=2021-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060021, encodeId=485f106002185, content=彩超或者CT引导下, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ece61961273, createdName=雲深無迹, createdTime=Wed Oct 13 07:25:31 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060002, encodeId=0e1a106000249, content=小日本货忍具喔垮塌下来, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Wed Oct 13 06:44:22 CST 2021, time=2021-10-13, status=1, ipAttribution=)]
    2022-02-07 xjy02
  7. 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    2021-10-14 smlt2008
  8. 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  9. 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    2021-10-13 雲深無迹

    彩超或者CT引导下

    0

  10. 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    2021-10-13 查查佳佳

    小日本货忍具喔垮塌下来

    0

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