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World J Gastroenterol. Jan 21, 2007; 13(3): 448-451
Published online Jan 21, 2007. doi: 10.3748/wjg.v13.i3.448
Liu-stain quick cytodiagnosis of ultrasound-guided fine needle aspiration in diagnosis of liver tumors
Chi-Sin Changchien, Jing-Houng Wang, Sheng-Nan Lu, Chao-Hung Hung, Chien-Hung Chen, Chuan-Mo Lee
Chi-Sin Changchien, Jing-Houng Wang, Sheng-Nan Lu, Chao-Hung Hung, Chien-Hung Chen, Chuan-Mo Lee, Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, College of Medicine, Taiwan, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Chi-Sin Changchien, Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, College of Medicine, 123, Ta-Pei road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan, China. cschangchien@adm.cgmh.org.tw
Telephone: +886-7-7317123 Fax: +886-7-7322402
Received: October 11, 2006
Revised: November 7, 2006
Accepted: December 4, 2006
Published online: January 21, 2007
Abstract

AIM: To combine ultrasound-guided fine-needle aspiration (US-FNA) and Liu (Riu) stain to make a quick study on liver tumor lesions.

METHODS: Two hundred and twenty-eight aspirations from 232 patients were completely studied. The operator himself made the quick cytodiagnosis of US-FNA smear stained by Liu method within thirty minutes. The US-FNA specimen was also sent to the pathological department for cytological study and cellblock histology. The result of our Liu-stain quick cytodiagnosis in each patient was confirmed by the final cytopathological diagnosis from pathological report.

RESULTS: Among 228 samples, the quick cytodiagnosis revealed 146 malignancies, 81 benign lesions and one inadequate specimen. Cytopathological diagnosis from the pathological department revealed 150 malignancies, and 78 benign lesions. Four well-differentiated hepatocellular carcinomas (HCCs) were under-diagnosed by quick cytodiagnosis as benign and 3 benign lesions were over-diagnosed as well-differentiated HCCs. Compared with cytopathological diagnosis, quick cytodiagnosis correctly diagnosed 143 malignancies and 77 benign lesions. Except for the one inadequate specimen in quick cytodiagnosis, the accuracy of quick cytodiagnosis was 96.9% (220/227), and its sensitivity, specificity and positive and negative predictive values were 97.9%, 95.1%, 97.3% and 96.3%, respectively.

CONCLUSION: Liu-stain quick cytodiagnosis is a fast, convenient, safe and effective method for hepatologists in clinic practice to diagnose liver tumor. In few cases of well-differentiated HCC, Liu-stain quick cytodiagnosis has its limitation.

Keywords: Liver tumor; Cytology; Ultrasound guided FNA; Liu stain