6) Immunohistochemistry: PCT is positive in 77% of FLC, but absent in other primary or secondary liver tumors.

In conclusion
👉 serum and tumor PCT = sensitive & specific biomarker for fibrolamellar hepatocellular carcinoma.

5) CALCA (the PCT gene) is strongly overexpressed in FLC and spatial transcriptomics localizes CALCA to tumor cells.

4) In 4 FLC patients, PCT tracked RECIST response under systemic treatment: ↓ in partial response, ↑ in progression, ↔ in stable disease. A promising dynamic monitoring marker.

3) Serum PCT is markedly elevated in FLC vs HCC, CCA or cirrhosis, in both EU & US cohorts.
👉 83% high PCT in FLC vs 0 to 3% in HCC or CCA.

2) Fibrolamellar carcinoma (FLC) affects young patients and lacks reliable biomarkers (AFP/CA19-9 usually normal). An unexpectedly high PCT level in one case led us to investigate PCT across two cohorts (Europe and USA)

Yes sure !

7/ In conclusion,
Systematic biopsies during RFA = safe + informative.
They can sharpen diagnosis, guide therapy & predict prognosis in newly diagnosed HCC. #HCC #LiverCancer #Biopsy

6/
🧾 Non-tumor biopsy insights
82% showed histological cirrhosis, but 15% had discrepancies with tumor board diagnosis—underlining the clinical relevance of liver biopsies beyond the tumor.

5/
🧬 Biopsy for molecular analysis
Samples with >25% tumor cells enabled transcriptomic analysis, validating their use for future molecular profiling and personalized treatment strategies.

4/
⚠️ Prognostic implications
Biopsy uncovered 3% cholangiocarcinoma/hepatocholangiocarcinoma—linked to significantly shorter survival.
Also, macrotrabecular-massive HCC subtype had higher recurrence (P=0.037).

3/
🔬 Diagnostic value
Tumor biopsy confirmed HCC in 66% of cases. Diagnostic yield was better with:
✔️ Larger nodules
✔️ Peripheral location
✔️ Good ultrasound visibility
34% were non-diagnostic, 5% differed from prior board diagnosis (hepatocholangiocarcinoma, cholangiocarcinoma, dysplastic nodules)

2/We looked in 248 patients at safety, diagnostic yield & prognostic insights from tumor + non-tumor biopsies.
✅ Safety first
Biopsies done during RFA had a low complication rate:
🔹 Bleeding in only 1.9% of cases
🔹 No biopsy-related deaths