Liver puncture examination cannot completely diagnose liver cancer

Liver biopsy is a method of puncturing a suspected lesion in the liver to obtain good tissue for pathological examination in order to diagnose liver cancer or other liver diseases.

Like many other tumors, pathological diagnosis is the "gold standard" for all liver cancer diagnoses, and liver biopsy is the only means to obtain lesion specimens besides surgical resection. Compared with laboratory and imaging examinations, liver puncture is an invasive examination and therefore involves certain risks.

Routine liver biochemical examination, coagulation function test, blood routine, platelet test, chest X-ray and abdominal ultrasound examination should be performed 1 to 2 days before liver puncture. The puncture point should be determined by ultrasound 1 day before the operation, and whether there are large blood vessels or enlarged gallbladder around to determine whether liver puncture can be performed. Patients with diseases such as prolonged coagulation time, intrahepatic cholestasis, hepatic echinococcosis, liver cysts, hepatic hemangioma, obstructive jaundice, infection, etc. should never undergo liver puncture.

For patients with a clear history of liver cancer or cirrhosis and imaging examinations showing characteristic changes of liver cancer, a diagnosis can be made without a liver biopsy. However, for patients with negative alpha-fetoprotein results, a liver biopsy can be considered.

However, fine needle puncture is currently used in clinical practice, which can only obtain a small amount of liver tissue. In addition, due to the different degrees of differentiation in tumor tissue, liver biopsy also has a certain degree of false negatives. Therefore, even if the result of liver biopsy is negative, it should be carefully judged in combination with other examinations.