Title: Histology obtained by needle biopsy gives additional information on the prognosis of hepatocellular carcinoma
Authors: van Malenstein, Hannah ×
Komuta, MIna
Verslype, Chris
Vandecaveye, Vincent
Van Calster, Ben
Topal, Baki
Laleman, Wim
Cassiman, David
Van Steenbergen, Werner
Aerts, Raymond
Vanbeckevoort, Dirk
Bielen, Didier
Pirenne, Jacques
van Pelt, Jos
Roskams, Tania
Nevens, Frederik #
Issue Date: Oct-2012
Publisher: Elsevier
Series Title: Hepatology Research vol:42 issue:10 pages:990-998
Abstract: 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.
ISSN: 1386-6346
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hepatology
Translational Cell & Tissue Research
Laboratory of Nephrology
Translational MRI (+)
Abdominal Surgical Oncology
× corresponding author
# (joint) last author

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