[The value of ultrasound-guided puncture biopsy in alpha-fetoprotein negative liver occupying lesions]

Objective: To investigate the accuracy and safety of ultrasound-guided puncture biopsy and enhanced MRI in the diagnosis of alpha-fetoprotein (AFP) negative liver occupying lesions. Methods: Retrospective analysis was conducted on the clinical data of 59 patients with liver occupying lesions who were admitted to the Fifth Medical Center of the PLA General Hospital from February 2015 to November 2017 and received ultrasound-guided coarse needle biopsy with AFP negative. Among them, 35 cases were males and 24 cases were females, the age range was from 25 to 67 years,with an average age of (51±3) years. Serum AFP in all patients were within the normal range. The difference between the pathological results of ultrasound-guided biopsy and the diagnosis of lesions by enhanced MRI was compared, and the diagnostic value of ultrasound-guided biopsy was analyzed. Meanwhile, complications during and after puncture were recorded. SPSS 24.0 software was used for statistical analysis.The measurement data were expressed as x±s and enumeration data were expressed as rate,if the P value was less than 0.05, it indicated that the difference was statistically significant. Results: There were 32 malignant cases and 27 benign cases based on the final pathological diagnosis. The sensitivity and specificity of ultrasound-guided needle biopsy were 100%, in contrast, the enhanced MRI was 96.9% and 81.5%, respectively, with the former significantly higher than the latter. There were no abdominal bleeding,infections and pneumothoraxduring and after the puncture. Conclusion: Ultrasound-guided puncture biopsy and enhanced MRI are both safe for the diagnosis of AFP negative liver occupying lesions,but the former is more sensitive than the latter.When the clinical symptoms of the patient are relatively mild and there is uncertainty in the diagnosis due to the lack of specific enhanced imaging, ultrasound-guided puncture is more conducive to identifying the nature of the lesion.