Role of Fine Needle Aspiration Cytology in Management of Hepatocellular Carcinoma: A Single Centre ExperienceReportar como inadecuado

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Collegium antropologicum, Vol.34 No.2 June 2010. -

Hepatocellular carcinoma HCC mostly occurs in chronic liver disease and cirrhosis. Liver resection and liver transplantation LT represent potentially curative treatments of choice and if not feasible, palliative strategies such as percutaneous interventional techniques PITs and chemotherapy ChT are considered. Elevated alfa-fetoprotein, typical imaging pattern, needle core biopsy NCB and fine needle aspiration cytology FNAC complement diagnostic assessment of HCC. We have retrospectively analyzed all patients with contraindications for NCB in which HCC was diagnosed by FNAC during consecutive 5 years in our hospital. Ultrasound guided FNAC provided a safe method of approach and, except for mild transitory discomfort at the site of puncture, no complications were documented. The diagnosis was established on May-Grünwald-Giemsa MGG stained aspirates and additional immunocytochemistry. Of our 62 patients, HCC developed in 61.3% cirrhotic and 38.7% non-cirrhotic livers. In the setting of cirrhosis 18.4% of patients underwent LT, 15.8% PITs, 26.3% ChT and 39.5% symptomatic therapy. In non-cirrhotic setting 46% of patients underwent liver resection, and PIT, ChT, and symptomatic therapy were applied in 4%, 25%, 25% of cases, respectively. Pathohistology of resected and explanted livers 18 cases confirmed the initial diagnosis made on FNAC. Since only early stage of HCC has a better prognosis, every effort should be made to establish prompt and accurate diagnosis. Our observations demonstrate that FNAC offers minimally invasive, rapid and uncomplicated diagnostic approach, with sensitivity from 67% to 93% and specificity from 96% to 100%. FNAC, is of utmost importance in the setting of abnormal coagulation tests and ascites commonly seen in advanced liver disease, facilitating diagnostic workup and treatment decisions.

hepatocellular carcinoma HCC; fine needle aspiration cytology FNCA; treatment

Autor: Anna Mrzljak - Ika Kardum-Skelin - Vesna Čolić Cvrlje - Tajana Filipec-Kanižaj - Dunja Šušterčić - Dinko Škegro -



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