Effectiveness of ultrasound-guided percutaneous transhepatic puncture for the diagnosis of low-level alpha-fetoprotein liver cancer patients

Yeliu Fu; Junyao Chen; Caiyang Li; Lie Chen; Zhilan Zhang; Zhenxiu Huang

doi:10.21037/tcr-21-701

Effectiveness of ultrasound-guided percutaneous transhepatic puncture for the diagnosis of low-level alpha-fetoprotein liver cancer patients

Transl Cancer Res. 2021 Jun;10(6):2985-2990. doi: 10.21037/tcr-21-701.

Authors

Yeliu Fu^#¹, Junyao Chen^#², Caiyang Li², Lie Chen¹, Zhilan Zhang¹, Zhenxiu Huang³

Affiliations

¹ Department of Medical Ultrasonics, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China.
² Department of Ultrasonography, Hainan Cancer Hospital, Haikou, China.
³ Department of Ultrasonography, Wanning People's Hospital, Wanning, China.

^# Contributed equally.

Abstract

Background: Globally, liver cancer is the most frequent fatal malignancy. The aim of the present study was to explore the effectiveness of ultrasound (US)-guided percutaneous transhepatic puncture in patients with low-level alpha-fetoprotein (AFP) liver cancer.

Methods: A total of 300 patients with primary liver cancer (PLC) (with AFP level ≤200 ng/mL and who underwent fine-needle aspiration) who were admitted to Central South University Xiangya School of Medicine Affiliated Haikou Hospital from January 2016 to December 2020 were selected to participate in the present study. Data, such as the expression of AFP and the biological characteristics of cells related to follow-up information, were retrospectively analyzed.

Results: Patients with AFP content <50 ng/mL accounted for 27% of total patients. Patients with tumors <20 mm accounted for 11% of total patients. There were 88 patients with 0-50 ng/mL AFP, 75 patients with 51-100 ng/mL AFP, 57 patients with 101-150 ng/mL AFP, and 83 patients with 200 ng/mL AFP. The sensitivity of detection was ≥90%, specificity was 100%, PPV was 100%, and NPV was ≥90%. In the present study, 34 patients with tumors <20 mm in size underwent US-guided percutaneous transhepatic puncture. The sensitivity of the treatment was 93.33%, 100% specificity, 100% PPV, and 64.35% NPV. The sensitivity of US-guided percutaneous transhepatic puncture was 97.65%, 100% specificity, 100% PPV, and 55.42% NPV in 266 patients with tumor size >20 mm. Implantation and metastasis accounted for 5% of complications, and gastrointestinal bleeding accounted for 7%. Among the adverse reactions, nausea and vomiting accounted for 15%, diarrhea accounted for 10%, and bone marrow suppression accounted for 8%.

Conclusions: US-guided percutaneous transhepatic puncture has high sensitivity, high specificity, and is relatively safe, with a low complication rate in patients with low-level AFP liver cancer, and has certain clinical diagnostic value.

Keywords: Liver cancer; alpha-fetoprotein (AFP); complications; effectiveness; fine-needle aspiration.