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Abstract
Modern oncology increasingly relies on pathological, molecular, and genomic assessments of biopsied tumor tissue. However, the concern for bleeding complication and malignant seeding severely hinders the application of the biopsy tumor. Here, we developed a 16 G biopsy needle to contain two electrodes insulated from each other and connect to an radiofrequency generator. For evaluating hemostatic efficacy, 50 rabbits were randomly divided into two groups: warfarinization and non-warfarinization group. Two liver biopsies and two splenic biopsies per animal were performed using a 16 G biopsy needle. Each group was further equally divided into five groups according to different hemostatic measures, including non-intervention, embolization using an absorbable gelatin sponge, and ablation by RF with three different needle temperatures (50°C, 70°C, and 90°C). Than, we used VX2 rabbit models (n = 25) and applied the five analogous biopsies to the tumor. The flush fluid from the biopsy needle underwent cytomorphological analysis. Our results that the groups using ablation by RF showed significantly less blood loss than the control group for liver and spleen in both groups (P < 0.001). After RF ablation, thermal coagulation of the tissue surrounding the needle tract was observed on both the macroscopic and histological level. Cytological smears showed that tumor cells were degenerated after RF at 70°C and 90°C. Our findings showed that bipolar RF biopsy needle is a promising tool for reducing hemorrhage after biopsy and avoiding implanting tumor cells in the tract.
Highlights
Modern oncology increasingly relies on pathological, molecular, and genomic assessments of biopsied tumor tissue to guide treatment selection and evaluate therapeutic response or resistance [1]
The results of the Tukey–Kramer test for multiple comparisons of post-biopsy bleeding amounts are illustrated in Tables 1, 2 and Figure 3
Tract ablation is considered to be an effective mean for reducing hemorrhage after biopsy and dissemination of viable tumor cells in the tract, it is rarely performed in most clinical settings [23]
Summary
Modern oncology increasingly relies on pathological, molecular, and genomic assessments of biopsied tumor tissue to guide treatment selection and evaluate therapeutic response or resistance [1]. There are several methods of biopsy available, such as surgical biopsy, core needle biopsy (CNB), and fine needle aspiration (FNA) biopsy [2]. More accurate and reliable the pathology results are obtained with more biopsy specimens of larger size [3,4,5,6]. Given the concern for bleeding complication, the size and number of biopsy specimens to be taken are limited. Bleeding tendencies (coagulation defects, decreased platelet counts, or long-term warfarin therapies) and organs susceptible to bleeding (spleen) are absolute contraindications for biopsy [7]
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