Early systemic inflammatory response after ultrasound-guided percutaneous liver mass biopsy: Role of hematologic parameters

The acute inflammatory response to tissue damage from percutaneous liver biopsy has not been systematically characterized in the immediate post-procedural period. This study investigated changes in hematologic parameters during the early period following ultrasound-guided liver mass biopsies, focusing on the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammatory markers. A total of 127 patients who underwent ultrasound-guided liver mass biopsy between January 2015 and March 2018 were retrospectively reviewed. Complete blood counts were obtained from blood samples taken before and 4 hours after the procedure. NLR was calculated by dividing the neutrophil count by the lymphocyte count, and PLR by dividing the platelet count by the lymphocyte count. Based on pathology results, patients were categorized as having malignant (n=117) or benign (n=10) liver lesions. Pre- and post-procedure values were compared. The mean age of the patients was 66.9 ± 13.3 years. Post-procedurally, the median NLR increased from 2.68 to 3.19 (p<0.001), and median PLR increased from 137 to 152 (p=0.008). NLR increased in 64.6% of patients, and PLR increased in 57.5%. An increase of more than 30% from baseline was observed in 40.9% of patients for NLR and in 35.4% for PLR. Additionally, a significant decrease in hemoglobin levels (mean decrease of 0.6 g/dL) was observed (p<0.001). The research results maintained their statistical power after the Bonferroni correction was applied to account for multiple comparisons. A significant early systemic inflammatory response occurs following percutaneous liver biopsy. Increases in NLR and PLR values support this observation. We conducted the first investigation which measured NLR and PLR values during the first four hours after patients underwent percutaneous liver biopsy. The clinical value of these changes requires future studies to validate their effects on patient outcomes because a clear association with improved patient outcomes has not been established.