Clinical value of pre-ablation biopsy in the differential diagnosis of suspected liver metastases

ZHANG Ningshi; ZHOU Shangjun; WANG Zaiguo; CHEN Yunhao; LIAO Xiaoying; ZHAN Ping; MAI Zhenhao; DENG Ruibin; LI Haoquan; JIANG Jingzhu; YE Zhenwei

doi:10.3969/j.issn.1674-4136.2025.05.013

Abstract：Objective To explore the clinical value of pre-ablation needle biopsy in the differential diagnosis of patients suspected with liver metastases.Methods A retrospective analysis was conducted on the clinical data and pathological examination results of 32 patients suspected with liver metastases who underwent needle biopsy before ablation at the Hepatobiliary and Pancreatic Center of Dongguan Hospital of Guangzhou University of Chinese Medicine and the Department of Hepatobiliary and Pancreatic Surgery of the Tenth Affiliated Hospital of Southern Medical University from January 2023 to April 2025.Results All patients in the group were preoperatively diagnosed with suspected liver metastases.Postoperative pathological diagnosis confirmed liver metastases in 22 cases(68.8％)and non-liver metastases in 10 cases(31.2％).The latter included hepatocellular carcinoma in 5 cases,cholangiocarcinoma in 1 case,hepatocellular adenoma in 1 case,neuroendocrine carcinoma in 1 case,hepatic hemangioma in 1 case,and inflammatory nodular lesion of the liver in 1 case.The consistency rate between preoperative diagnosis and postoperative pathological diagnosis was 68.8％.The success rate of needle biopsy and microwave ablation surgery was 100％for the entire group.Postoperative complications included minor perihepatic hemorrhage and small right pleural effusion in 1 case each(3.1％),both of which resolved spontaneously without special treatment.Postoperative enhanced CT scans at 2-4 weeks evaluated the ablation effect,showing complete ablation in all 32 cases(100％)with no cases of partial ablation.Conclusions Pre-ablation needle biopsy is simple,safe,and reliable.It can achieve differential diagnosis through pathological analysis,thereby avoiding misdiagnosis and mistreatment.Therefore,it is recommended to routinely perform needle biopsy for patients suspected with liver metastases before implementing precise microwave ablation.