Yuh-Yuan Tsai*,**, Sheng-Nan
Lu**, Chi-Sin Changchien**,
Chuan-Mo Lee**, Jing-Houng Wang**,
Hock-Liew Eng***, and Wei-Chi Chang****
Department of Internal Medicine, *Kaohsiung Military
General Hospital;
Division of Hepato-Gastroenterology, **Department
of Internal Medicine
and ***Department of Pathology, Kaohsiung Chang
Gung Memorial Hospital;
and ****Gau Bor Pathologic Center, Kaohsiung
Ultrasound (US)-guided fine needle aspiration
(FNA) is a fast and safe way to get a tissue sample for evaluation of liver
tumor. The objective of this study is to investigate the value of US-guided
22-gauge FNA smear cytology (SC) in diagnosing liver tumor. Through January
to June 1998, 43 liver tumor patients including hepatocellular carcinoma
(HCC) and non-HCC received 43 sessions of US-guided FNA were recruited.
Thirty-three malignant tumors including HCC and nonspecific malignancy
were confirmed by pathology. Ten benign tumor lesions (abscess, hemangioma
and nodules in cirrhotic liver) were confirmed by clinical course and follow-up
for at least 1 year without tumor progression. The sensitivity, specificity
and accuracy of US-guided 22-gauge FNA SC are 90.9%, 90% and 90.7%, respectively.
Furthermore, in diagnosing HCC, the sensitivity, specificity and accuracy
are 88.5%, 88.2% and 88.4%, respectively. To evaluate the interference
of tumor size, the sensitivities of using FNA SC in diagnosing HCC
are no statistical difference (< 2 cm, 100%; between 2-5 cm, 84.6%;
and > 5 cm, 100%). There is no immediate post-aspiration complication in
this study. In conclusion, US-guided 22-gauge FNA smear cytology
is a rapid, safe, inexpensive and reliable method in diagnosis of liver
malignancy. (J Intern Med Taiwan 1999;10:108-112)
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