Simon Chun Ho Yu, Dennis Yuk Ming Lo, Chei Bing Ip, Choong Tsek Liew, Thomas Wai Tong Leung, Wan Yee Lau
OBJECTIVE. Our purpose was to ﬁnd out whether percutaneous biopsy of hepatocellular carcinoma will cause signiﬁcant dissemination of tumor into the circulation by quantitative analysis of circulating tumor DNA.
SUBJECTS AND METHODS. In this prospective study of 32 patients with suspected hepatocellular carcinoma who underwent sonographically guided liver biopsy, a peripheral venous blood sample was obtained before and 5 min after the procedure. Biopsy was performed using an 18-gauge biopsy gun. DNA was extracted from the plasma of the blood samples for methylation-speciﬁc polymerase chain reaction. Quantitative measures of the plasma tumor DNA were determined with real-time quantitative polymerase chain reaction, and the amount was expressed as a methylation index (%) in plasma.
RESULTS. Nineteen (59.4%) of 32 patients did not have detectable p16 tumor suppressor gene marker (p16M) in plasma before biopsy, and they showed no detectable plasma p16M after biopsy. Thirteen (65%) of 20 patients had p16M identiﬁed in the plasma before liver biopsy. Quantitative analysis of the plasma tumor DNA in these 13 patients showed no statistically signiﬁcant difference in the methylation index before and after biopsy (p = 0.345, Wilcoxon’s signed rank test).
CONCLUSION. No evidence exists that percutaneous liver biopsy results in hematogenous dissemination of hepatocellular carcinoma as shown by quantitative analysis of circulating tumor DNA (p16M) using methylation-speciﬁc real-time polymerase chain reaction.
Full Publications: http://www.ajronline.org/content/183/2/383.full.pdf