Histopathological results.

PurposeUltrasound-guided biopsy of focal liver lesions (FLL) is a well-established procedure with crucial impact on therapeutic decisions. The safety and accuracy depend on needle type, tumour location and comorbidities. Modern oncological concepts often require large tumour specimens which may increase the procedural risk.Materials and methodsWe retrospectively collected data from consecutively scheduled ultrasound-guided FLL biopsies performed in an interdisciplinary ultrasound unit at a university hospital from 2015–2020. We analysed complication rates, diagnostic accuracy, and patient outcome in a one-year period.ResultsOf 426 scheduled interventions, 339 were included: 322 primary biopsies (40% female, median age 65 years, median BMI 25.4 kg/m2) and 17 rebiopsies in cases with undetermined diagnosis. Indications comprised 309 (96%) cases with suspected malignant lesions. Important comorbidities were type 2 diabetes (n = 107, 33%) and cirrhosis (n = 64, 20%). A conclusive histopathological diagnosis was achieved in 270 (84%) cases with a weak association with lesion size (OR 1.12 per cm, 95%CI 0.99–1.27). Greater BMI (OR 0.60 per 10 BMI points, 95%CI 0.34–1.05) showed a trend towards an insufficient diagnosis. Relevant complications occurred in 8 (2.5%) cases (2 major; 1 life-threatening). Multiple passes showed a trend towards adverse events (OR 2.32 for > 1 pass, 95%CI 0.99–5.42). 93 (29%) patients died during a median follow-up of 171 days.ConclusionUltrasound-guided FLL biopsy is an efficient and safe diagnostic measure. The limitations of the procedure and its associated risks should be considered in patients with advanced malignancies.

## 研究目的
超声引导下肝脏局灶性病变（focal liver lesions, FLL）穿刺活检是一项成熟的临床操作，对治疗决策具有至关重要的指导意义。该操作的安全性与诊断准确性取决于穿刺针类型、肿瘤位置及患者合并症情况。现代肿瘤学诊疗理念常要求获取较大体积的肿瘤标本，这可能会提升操作相关风险。

## 材料与方法
本研究回顾性收集了2015—2020年间，某大学医院跨学科超声科连续开展的超声引导下FLL穿刺活检的相关数据，并对为期1年的并发症发生率、诊断准确性及患者结局进行分析。

## 结果
原计划实施的426例操作中，最终纳入339例：其中322例为首次穿刺活检（女性占比40%，中位年龄65岁，中位体质量指数BMI为25.4 kg/m²），另有17例为诊断不明病例的再次活检。纳入病例的适应证以疑似恶性病变为主，共计309例（占比96%）。患者的重要合并症包括2型糖尿病（n=107，占33%）与肝硬化（n=64，占20%）。最终270例（84%）获得明确的组织病理学诊断，病变大小与诊断明确率呈弱相关（比值比OR=1.12/每厘米，95%置信区间CI：0.99~1.27）；较高的BMI（每10个BMI单位对应的OR=0.60，95%CI：0.34~1.05）呈现出诊断不充分的趋势。本研究中共8例（2.5%）患者发生相关并发症，其中2例为严重并发症，1例为危及生命的不良事件。多次穿刺操作呈现出不良事件发生的趋势（穿刺次数＞1次的OR=2.32，95%CI：0.99~5.42）。中位随访时间为171天，期间共有93例（29%）患者死亡。

## 结论
超声引导下FLL穿刺活检是一项高效且安全的诊断手段。对于合并晚期恶性肿瘤的患者，临床实践中应充分考量该操作的局限性及相关风险。