Ultrasound-guided fine-needle biopsy of hepatocellular carcinoma: comparison between smear cytology and microhistology.

Objectives: The aims of this study were to evaluate the typing accuracy of smear cytology and microhistology and of their association in the diagnosis of hepatocellular carcinoma arising in liver cirrhosis, and to analyze the usefulness of smear cytology in the diagnosis of well-differentiated neoplasms.

Methods: One hundred sixty patients with hepatocellular carcinoma underwent an ultrasound-guided fine-needle biopsy, providing material for cytological and histological study. In 73 patients, a double biopsy with noncutting and cutting needles was performed (double-needle group), whereas in the remaining 87, a single biopsy with cutting needle was carried out (single-needle group).

Results: In the whole population examined, smear cytology, microhistology, and their association, provided the diagnosis of hepatocellular carcinoma in 128 (80%), 98 (61%), and 144 (90%) cases, respectively. The double-needle and the single-needle groups did not differ significantly as to typing accuracy. Smear cytology correctly diagnosed 54 of 64 neoplasms classified histologically as well-differentiated.

Conclusions: Our results show that both smear cytology and microhistology should be applied immediately, when diagnosing hepatocellular carcinoma arising in liver cirrhosis, and that smear cytology is effective in the diagnosis of well-differentiated neoplasms.