Journal of Interventional Medicine最新文献

Baseline parameters of spectral CT could predict tumor response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients 光谱 CT 基线参数可预测肝细胞癌患者对经导管动脉化疗栓塞术的肿瘤反应

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2025-12-01 DOI: 10.1016/j.jimed.2023.12.005

Jian Lv , Ronghua Mu , Xiaoyan Qin , Wei Zheng , Peng Yang , Bingqin Huang , Xin Li , Fuzhen Liu , Xiqi Zhu

Objective

The present study aimed to assess the diagnostic efficacy of baseline spectral computed tomography (CT) parameters in predicting tumor response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).

Methods

Data were collected from 91 consecutive patients with HCC between June 2020 and July 2023. An independent samples t-test was performed to compare the demographic and spectral CT variables between the groups. Predictors were screened using binary logistic regression, and the diagnostic efficacy of the baseline parameters for predicting the response to TACE in patients with HCC was analyzed using receiver operating characteristic (ROC) curves.

Results

A total of 91 patients with HCC were included in the present study, categorized into response (n = 52; men, 48 (92.3 %); age, 58.72 ± 11.16 years) and non-response (n = 39; men, 36 (92.31 %); age, 59.50 ± 10.10 years) groups based on the evaluation criteria. There was a statistically significant difference in both iodine concentration (IC) and normalized IC (NIC) between the two groups (P < 0.05), and we found that the mean values of the three IC and NIC phases in the non-response group were significantly lower than those in the response group. The arterial, portal, and delayed phase ICs and NICs had significant positive effects on the response to TACE in patients with HCC (P < 0.05). Baseline spectral CT parameters, including IC and NIC, had satisfactory diagnostic efficacy for predicting tumor response to TACE (area under the curve [AUC] of baseline spectral parameters ranged from 0.698 to 0.879). The results of the DeLong test indicated no statistical differences between the AUC of all the parameters and models.

Conclusion

The present study found that the baseline spectral CT parameters could be surrogate imaging markers for predicting tumor response to TACE.

目的评价基线谱计算机断层扫描（CT）参数在预测肝细胞癌（HCC）患者对经导管动脉化疗栓塞（TACE）的肿瘤反应中的诊断效果。方法收集2020年6月至2023年7月连续91例HCC患者的数据。采用独立样本t检验比较两组间的人口学和光谱CT变量。使用二元logistic回归筛选预测因子，并使用受试者工作特征（ROC）曲线分析预测HCC患者TACE疗效的基线参数的诊断效果。结果本研究共纳入91例HCC患者，分为缓解组（n = 52），男性48例（92.3%）；年龄（58.72±11.16岁）和无反应(n = 39，男性36 (92.31%)；年龄（59.50±10.10岁）按评价标准分组。两组间碘浓度（IC）和归一化碘浓度（NIC）的差异均有统计学意义（P < 0.05），且我们发现无反应组的IC和NIC三个阶段的平均值均显著低于反应组。动脉、门静脉、延迟期ic和nic对HCC患者TACE疗效有显著的正向影响（P < 0.05）。基线光谱CT参数（包括IC和NIC）对预测肿瘤对TACE的反应具有满意的诊断效果（基线光谱参数曲线下面积[AUC]范围为0.698 ~ 0.879）。DeLong检验结果表明，各参数与模型的AUC均无统计学差异。结论CT基线谱参数可作为预测肿瘤TACE疗效的替代影像学指标。

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引用次数: 0

Validation of the CRAFITY score for predicting prognosis in patients with hepatocellular carcinoma undergoing transarterial chemoembolization combined with systemic therapy 对接受经动脉化疗栓塞术联合全身治疗的肝细胞癌患者预后预测的 CRAFITY 评分进行验证

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2025-12-01 DOI: 10.1016/j.jimed.2023.12.004

Haifeng Zhou , Jianwu Ren , Feida Wu , Wei Yang , Di Zhu, Yuguan Xie, Qi Shi, Zhongling Pei, Yan Shen, Lingling Wu, Sheng Liu, Haibin Shi, Weizhong Zhou

Background

The CRAFITY score can predict survival and radiological response to systemic front-line treatment in patient with hepatocellular carcinoma (HCC).

Aims

In this study, we aimed to externally validate the CRAFITY score and compare it with other simple prognostic models in patients with unresectable HCC who underwent transarterial chemoembolization (TACE) combined with systemic therapies.

Methods

Patients with unresectable HCC who underwent TACE combined with tyrosine kinase inhibitors (TKIs), with or without immune checkpoint inhibitors (ICIs), were retrospectively analyzed to determine whether the CRAFITY score can predict overall survival (OS) through multivariate analysis and Kaplan‒Meier curves. Prediction of 3- and 6-month objective response rates (ORRs) was validated by the area under the curve (AUC).

Results

Among 147 patients with unresectable HCC, 113 received TACE + TKI and 34 received TACE + TKI + ICI. The CRAFITY score was identified as an independent predictor for OS (P < 0.001) and showed a good ability to categorize all included patients into low-, moderate-, and high-risk groups (P < 0.001). For predicting the 3- and 6-month ORRs, the CRAFITY score exhibited poor performance, with AUCs of 0.555 and 0.515, respectively.

Conclusion

The CRAFITY score is effective in predicting OS but demonstrates limited accuracy in predicting 3- and 6-month ORRs for patients with unresectable HCC undergoing TACE combined with systemic therapies.

CRAFITY评分可以预测肝细胞癌（HCC）患者的生存和对系统性一线治疗的放射学反应。在这项研究中，我们旨在外部验证CRAFITY评分，并将其与其他简单的预后模型进行比较，这些模型适用于接受经动脉化疗栓塞（TACE）联合全身治疗的不可切除HCC患者。方法回顾性分析接受TACE联合酪氨酸激酶抑制剂（TKIs），联合或不联合免疫检查点抑制剂（ICIs）的不可切除HCC患者，通过多因素分析和Kaplan-Meier曲线确定CRAFITY评分是否可以预测总生存期（OS）。通过曲线下面积（AUC）验证3个月和6个月客观缓解率（orr）的预测。结果147例不可切除HCC患者中，TACE + TKI 113例，TACE + TKI + ICI 34例。CRAFITY评分被确定为OS的独立预测因子（P < 0.001），并显示出将所有纳入的患者分为低、中、高风险组的良好能力（P < 0.001）。对于预测3个月和6个月的orr， CRAFITY评分表现不佳，auc分别为0.555和0.515。结论CRAFITY评分可有效预测OS，但在预测不可切除HCC患者接受TACE联合全身治疗的3个月和6个月orr时准确性有限。

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引用次数: 0

Percutaneous radiofrequency and microwave ablation for renal pelvic urothelial carcinoma with refractory hematuria: A case report 经皮射频和微波消融术治疗伴有难治性血尿的肾盂尿路上皮癌：病例报告

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2025-12-01 DOI: 10.1016/j.jimed.2023.12.006

Wei-Guo Tang, Yu Wu, Juan-Juan Xu, Xi Li, Yuan Liu

Thermal ablation for renal cell carcinoma in nephron-sparing surgery has been extensively investigated. However, data regarding renal pelvic tumors with refractory hematuria are scarce. Herein, we report a case of recurrent hematuria in an 87-year-old woman with. a 3.5 × 4.1 cm mass in the right renal pelvis on imaging examinations, which was clinically diagnosed as renal pelvic carcinoma. After ineffective renal artery embolization, minimally invasive percutaneous thermal ablation was recommended after a multidisciplinary consultation. Although hematuria was successfully relieved after ultrasound-guided radiofrequency ablation initially, recurrence of hematuria was reported due to tumor progression after one year. CT-guided microwave ablation resolved hematuria and controlled tumor growth without complications. Upper tract urothelial carcinoma (UTUC) was confirmed by biopsy. Postoperative CT imaging, urine cytology, and renal function tests were continuously monitored during the follow-up. The patient remained stable during the 1-year follow-up period, highlighting the potential of thermal ablation for refractory hematuria in renal pelvis urothelial carcinoma while preserving nephrons.

热消融治疗肾细胞癌在保留肾单元手术中的应用已被广泛研究。然而，关于肾盆腔肿瘤合并难治性血尿的资料很少。在此，我们报告一例复发性血尿的87岁妇女与。右侧肾盂影像学检查见3.5 × 4.1 cm肿块，临床诊断为肾盂癌。肾动脉栓塞无效后，经多学科会诊推荐微创经皮热消融。虽然在超声引导下射频消融术后，血尿最初得到了成功的缓解，但由于肿瘤进展，一年后血尿复发。ct引导下微波消融术消除血尿，控制肿瘤生长，无并发症。活检证实为上尿路上皮癌（UTUC）。随访期间持续监测术后CT成像、尿细胞学检查和肾功能检查。在1年的随访期间，患者保持稳定，突出了热消融治疗肾盂尿路上皮癌难治性血尿的潜力，同时保留了肾单位。

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引用次数: 0

Diagnostic radiology: The essential for effective and safe practice of interventional radiology 放射诊断学：有效、安全地开展介入放射学实践的基本要素

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2025-12-01 DOI: 10.1016/j.jimed.2023.12.001

Xiaoming Yang

引用次数: 0

Chinese expert consensus on transradial access in percutaneous peripheral interventions 经皮外周介入经桡动脉入路的中国专家共识

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2023-11-01 DOI: 10.1016/j.jimed.2023.10.005

Minjie Yang , Sen Jiang , Yanli Wang , Xiaoxi Meng , Liwen Guo , Wen Zhang , Xin Zhou , Zhiping Yan , Jiarui Li , Weihua Dong

Transradial access (TRA) is a safe and comfortable approach and the preferred access for percutaneous coronary intervention. However, TRA is not widely used for peripheral interventions. Currently, there is a lack of data on patient selection, appropriate medical devices, complication prevention, and TRA adoption. Therefore, the Chinese Society of Interventional Oncology of the China Anti-Cancer Association organized nationwide experts to establish a Working Group of China Expert Consensus on TRA in percutaneous peripheral interventions in 2022, and jointly formulated this consensus to better promote the application of TRA in peripheral interventions to guide clinicians on patient selection, technical recommendations, and physician training. This consensus mainly focuses on the current situation, advantages and limitations of TRA in peripheral interventions, anatomical characteristics of the radial artery, patient selection, technical aspects, prevention and management of complications, radiation dose, and learning curve. A consensus was reached through a literature evaluation and by referring to the opinions of the expert group.

经桡动脉入路（TRA）是一种安全舒适的方法，也是经皮冠状动脉介入治疗的首选入路。然而，经桡动脉入路并没有广泛用于外周介入治疗。目前，在患者选择、合适的医疗器械、并发症预防以及 TRA 的采用方面缺乏数据。因此，中国抗癌协会肿瘤介入学分会组织全国专家成立了2022年经皮外周介入治疗TRA中国专家共识工作组，共同制定了本共识，以更好地推动TRA在外周介入治疗中的应用，从患者选择、技术建议、医生培训等方面指导临床医生。本共识主要针对TRA在外周介入治疗中的现状、优势和局限、桡动脉的解剖特点、患者选择、技术方面、并发症的预防和处理、放射剂量和学习曲线等方面进行了阐述。通过文献评估和参考专家组的意见达成了共识。

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引用次数: 0

A novel cerebrovascular drug-coated balloon catheter for treating symptomatic intracranial atherosclerotic stenosis lesions: Study protocol for a prospective, multicenter, single-arm, target-value clinical trial 用于治疗症状性颅内动脉粥样硬化性狭窄病变的新型脑血管药物涂层球囊导管：前瞻性、多中心、单臂、目标值临床试验研究方案

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2023-11-01 DOI: 10.1016/j.jimed.2023.10.001

Qianhao Ding , Wenbo Liu , Jingge Zhao , Dehua Guo , Yao Tang , Tengfei Zhou , Yanyan He , Ferdinand K. Hui , Yonghong Ding , Liangfu Zhu , Zilang Wang , Yingkun He , Tianxiao Li

Background

Previous single-center studies have demonstrated that drug-coated balloons (DCBs) may reduce restenosis rates, which is an important factor affecting the prognosis for intracranial interventional therapy. However, currently available cardiac DCBs are not always suitable for the treatment of intracranial atherosclerotic stenosis (ICAS). This study aimed to evaluate the safety and efficacy of a novel DCB catheter designed for patients with severely symptomatic ICAS.

Methods

This prospective, multicenter, single-arm, target-value clinical trial was conducted in 9 Chinese stroke centers to evaluate the safety and efficacy of a novel DCB catheter for treating symptomatic severe ICAS. Primary metrics and other indicators were collected and analyzed using SAS version 9.4 (SAS Institute, Cary, NC, USA).

Results

A total of 155 patients were enrolled in this study. The preliminary collection of follow-up data has been completed, while data quality control is ongoing.

Conclusion

Results of this study demonstrated the patency rate, safety, and effectiveness of a novel on-label paclitaxel DCB designed for the treatment of ICAS.

Trial registration

ChiCTR, ChiCTR2100047223. Registered June 11, 2021-Prospective registration, https://www.chictr.org.cn/ChiCTR2100047223.

背景以前的单中心研究表明，药物涂层球囊（DCB）可降低再狭窄率，而再狭窄率是影响颅内介入治疗预后的一个重要因素。然而，目前可用的心脏 DCB 并不总是适合治疗颅内动脉粥样硬化性狭窄（ICAS）。这项前瞻性、多中心、单臂、目标值临床试验在中国的9个卒中中心进行，旨在评估新型DCB导管治疗无症状重度ICAS的安全性和有效性。研究使用 SAS 9.4 版（SAS Institute，Cary，NC，USA）对主要指标和其他指标进行了收集和分析。结论本研究结果表明，标签上的新型紫杉醇 DCB 专为治疗 ICAS 而设计，具有通畅率、安全性和有效性。注册日期：2021年6月11日-前瞻性注册，https://www.chictr.org.cn/ChiCTR2100047223。

{"title":"A novel cerebrovascular drug-coated balloon catheter for treating symptomatic intracranial atherosclerotic stenosis lesions: Study protocol for a prospective, multicenter, single-arm, target-value clinical trial","authors":"Qianhao Ding , Wenbo Liu , Jingge Zhao , Dehua Guo , Yao Tang , Tengfei Zhou , Yanyan He , Ferdinand K. Hui , Yonghong Ding , Liangfu Zhu , Zilang Wang , Yingkun He , Tianxiao Li","doi":"10.1016/j.jimed.2023.10.001","DOIUrl":"10.1016/j.jimed.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Previous single-center studies have demonstrated that drug-coated balloons (DCBs) may reduce restenosis rates, which is an important factor affecting the prognosis for intracranial interventional therapy. However, currently available cardiac DCBs are not always suitable for the treatment of intracranial atherosclerotic stenosis (ICAS). This study aimed to evaluate the safety and efficacy of a novel DCB catheter designed for patients with severely symptomatic ICAS.</p></div><div><h3>Methods</h3><p>This prospective, multicenter, single-arm, target-value clinical trial was conducted in 9 Chinese stroke centers to evaluate the safety and efficacy of a novel DCB catheter for treating symptomatic severe ICAS. Primary metrics and other indicators were collected and analyzed using SAS version 9.4 (SAS Institute, Cary, NC, USA).</p></div><div><h3>Results</h3><p>A total of 155 patients were enrolled in this study. The preliminary collection of follow-up data has been completed, while data quality control is ongoing.</p></div><div><h3>Conclusion</h3><p>Results of this study demonstrated the patency rate, safety, and effectiveness of a novel on-label paclitaxel DCB designed for the treatment of ICAS.</p></div><div><h3>Trial registration</h3><p>ChiCTR, ChiCTR2100047223. Registered June 11, 2021-Prospective registration, <span>https://www.chictr.org.cn/ChiCTR2100047223</span><svg><path></path></svg>.</p></div>","PeriodicalId":33533,"journal":{"name":"Journal of Interventional Medicine","volume":"6 4","pages":"Pages 180-186"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2096360223000509/pdfft?md5=006fb83c21cb784f33f998c779d04aa7&pid=1-s2.0-S2096360223000509-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136094051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Argon-helium cryoablation treatment of undifferentiated pleomorphic sarcoma of the thyroid: A case report and literature review 氩氦冷冻消融治疗甲状腺未分化多形性肉瘤：病例报告和文献综述

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2023-11-01 DOI: 10.1016/j.jimed.2023.10.002

Xuyang Zhang, Yan Sun

Undifferentiated pleomorphic sarcoma is an extremely rare malignant thyroid tumor. Thyroid sarcoma differs from common malignant thyroid tumors, such as thyroid follicular cell carcinoma. It is usually highly malignant, progresses rapidly, and is prone to remote metastasis. Currently, there is no standard protocol for the treatment of thyroid sarcomas, and most treatment effects are unsatisfactory. Argon-helium cryoablation is an important method of local treatment that is widely used in patients with unresectable advanced tumors. However, owing to the low incidence of thyroid sarcomas, there are no relevant literature reports on the treatment of thyroid sarcomas using cryoablation in China. This study reports the case of a patient with undifferentiated pleomorphic sarcoma of the thyroid gland who was treated with argon-helium cryoablation, and the immediate outcome was good. Based on a review of relevant literature, we discussed the effectiveness and safety of argon-helium cryoablation treatment to provide clinical guidance and references for the treatment of patients with thyroid sarcoma.

未分化多形性肉瘤是一种极为罕见的甲状腺恶性肿瘤。甲状腺肉瘤不同于甲状腺滤泡细胞癌等常见的甲状腺恶性肿瘤。它通常恶性程度高，进展迅速，容易发生远处转移。目前，还没有治疗甲状腺肉瘤的标准方案，大多数治疗效果并不理想。氩氦冷冻消融是一种重要的局部治疗方法，广泛应用于无法切除的晚期肿瘤患者。然而，由于甲状腺肉瘤发病率较低，国内尚无冷冻消融治疗甲状腺肉瘤的相关文献报道。本研究报告了一例甲状腺未分化多形性肉瘤患者接受氩氦刀冷冻消融治疗的病例，术后效果良好。在回顾相关文献的基础上，探讨了氩氦刀冷冻消融治疗的有效性和安全性，为甲状腺肉瘤患者的治疗提供临床指导和参考。

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引用次数: 0

Combination of transarterial radioembolization with atezolizumab and bevacizumab for intermediate and advanced staged hepatocellular carcinoma: A preliminary report of safety and feasibility 经动脉放射栓塞术与阿特珠单抗和贝伐单抗联合治疗中晚期分期肝细胞癌：安全性和可行性初步报告

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2023-11-01 DOI: 10.1016/j.jimed.2023.09.002

Qian Yu , Yating Wang , Ethan Ungchusri , Mikin Patel , Divya Kumari , Thuong Van Ha , Anjana Pillai , Chih-yi Liao , Osman Ahmed

Purpose

The IMbrave150 Phase III trial demonstrated the superiority of atezolizumab and bevacizumab (Atezo/Bev) over sorafenib for unresectable hepatocellular carcinoma (HCC). The present study aims to evaluate the feasibility of TARE in combination with Atezo/Bev for the treatment of intermediate and advanced staged HCC.

Methods

A retrospective review at a single institution was performed between May 2021 and December 2022. Patients who received TARE using yttrium-90 (Y90) with concomitant or sequential Atezo/Bev systemic treatment were included. The following outcomes were retrieved: overall survival (OS), radiologic tumor response, progression-free survival, technical adverse events related to TARE, and toxicity based on the National Cancer Institute–Common Terminology Criteria for Adverse Events version 5.0.

Results

Ten consecutive patients with intermediate (n = 4) and advanced stage HCC (n = 6) were treated with TARE and sequential/concomitant Atezo/Bev. Tumor control was achieved in all TARE-treated target lesions (100%). Overall disease progression occurred in 4 patients with PFS of 78.8% and 66.7% at 6- and 12- months, respectively. Two patients died at follow-up, with 6-month and 12-month OS rates of 90.0% and 77.1%, respectively. Three (75%) patients with intermediate stage disease were downstaged into Milan criteria. One patient developed grade 3 transaminitis and hypoglobulinemia, while Atezo/Bev was switched to Lenvatinib in another patient due to immunotherapy related myositis.

Conclusion

This study demonstrates the initial safety and feasibility of combined TARE with Atezo/Bev for intermediate/advanced stage HCC. Further prospective studies with larger sample sizes are warranted.

目的IMbrave150 III期试验表明，阿特珠单抗和贝伐单抗（Atezo/Bev）治疗不可切除肝细胞癌（HCC）的疗效优于索拉非尼。本研究旨在评估TARE联合Atezo/Bev治疗中晚期HCC的可行性。方法2021年5月至2022年12月期间，在一家机构进行了回顾性研究。纳入的患者均接受了使用钇-90（Y90）的TARE治疗，并同时或连续接受了Atezo/Bev系统治疗。根据美国国立癌症研究所--不良事件通用术语标准5.0版，检索了以下结果：总生存期（OS）、肿瘤放射学反应、无进展生存期、与TARE相关的技术性不良事件和毒性。结果10例连续的中晚期HCC患者（4例）接受了TARE和相继/相伴Atezo/Bev治疗。所有经 TARE 治疗的目标病灶均实现了肿瘤控制（100%）。4名患者出现了总体疾病进展，6个月和12个月的PFS分别为78.8%和66.7%。两名患者在随访期间死亡，6 个月和 12 个月的 OS 率分别为 90.0% 和 77.1%。三名（75%）中期患者被降级为米兰标准。一名患者出现了3级转氨酶炎和低球蛋白血症，另一名患者因免疫治疗相关肌炎而将Atezo/Bev换成了Lenvatinib。有必要进一步开展样本量更大的前瞻性研究。

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引用次数: 0

Current status of yttrium-90 microspheres radioembolization in primary and metastatic liver cancer 钇-90微球放射栓塞治疗原发性和转移性肝癌的现状

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2023-11-01 DOI: 10.1016/j.jimed.2023.09.001

Yasaman Anbari , Floortje E. Veerman , Grace Keane , Arthur J.A.T. Braat , Maarten L.J. Smits , Rutger C.G. Bruijnen , Wenle Tan , Ye Li , Feng Duan , Marnix G.E.H. Lam

Liver malignancy, including primary liver cancer and metastatic liver cancer, has become one of the most common causes of cancer-related death worldwide due to the high malignant degree and limited systematic treatment strategy. Radioembolization with yttrium-90 (⁹⁰Y)-loaded microspheres is a relatively novel technology that has made significant progress in the local treatment of liver malignancy. The different steps in the extensive work-up of radioembolization for patients with an indication for treatment with ⁹⁰Y microspheres, from patient selection to follow up, both technically and clinically, are discussed in this paper. It describes the application and development of ⁹⁰Y microspheres in the treatment of liver cancer.

肝脏恶性肿瘤，包括原发性肝癌和转移性肝癌，由于恶性程度高、系统治疗策略有限，已成为全球最常见的癌症相关死亡原因之一。钇-90（90Y）负载微球放射栓塞是一种相对新颖的技术，在肝脏恶性肿瘤的局部治疗方面取得了重大进展。本文从技术和临床两方面讨论了对有 90Y 微球治疗适应症的患者进行放射性栓塞治疗的大量工作中，从患者选择到随访的不同步骤。本文介绍了 90Y 微球在肝癌治疗中的应用和发展。

引用次数: 0

Mechanisms and therapeutic strategies to combat the recurrence and progression of hepatocellular carcinoma after thermal ablation 抗击肝细胞癌热消融术后复发和进展的机制和治疗策略

Q3 Medicine

Journal of Interventional Medicine

Pub Date : 2023-11-01 DOI: 10.1016/j.jimed.2023.10.004

Feilong Ye , Lulu Xie , Licong Liang , Zhimei Zhou, Siqin He, Rui Li, Liteng Lin, Kangshun Zhu

Thermal ablation (TA), including radiofrequency ablation (RFA) and microwave ablation (MWA), has become the main treatment for early-stage hepatocellular carcinoma (HCC) due to advantages such as safety and minimal invasiveness. However, HCC is prone to local recurrence, with more aggressive malignancies after TA closely related to TA-induced changes in epithelial-mesenchymal transition (EMT) and remodeling of the tumor microenvironment (TME). According to many studies, various components of the TME undergo complex changes after TA, such as the recruitment of innate and adaptive immune cells, the release of tumor-associated antigens (TAAs) and various cytokines, the formation of a hypoxic microenvironment, and tumor angiogenesis. Changes in the TME after TA can partly enhance the anti-tumor immune response; however, this response is weak to kill the tumor completely. Certain components of the TME can induce an immunosuppressive microenvironment through complex interactions, leading to tumor recurrence and progression. How the TME is remodeled after TA and the mechanism by which the TME promotes HCC recurrence and progression are unclear. Thus, in this review, we focused on these issues to highlight potentially effective strategies for reducing and preventing the recurrence and progression of HCC after TA.

热消融（TA），包括射频消融（RFA）和微波消融（MWA），因其安全、微创等优点已成为早期肝细胞癌（HCC）的主要治疗方法。然而，HCC容易局部复发，TA术后出现侵袭性恶性肿瘤与TA诱导的上皮-间质转化（EMT）变化和肿瘤微环境（TME）重塑密切相关。许多研究表明，TA发生后，肿瘤微环境的各种成分会发生复杂的变化，如先天性和适应性免疫细胞的募集、肿瘤相关抗原（TAA）和各种细胞因子的释放、缺氧微环境的形成以及肿瘤血管生成等。TA后TME的变化可部分增强抗肿瘤免疫反应，但这种反应很弱，无法完全杀死肿瘤。TME的某些成分可通过复杂的相互作用诱导免疫抑制微环境，导致肿瘤复发和进展。TA发生后TME如何重塑以及TME促进HCC复发和进展的机制尚不清楚。因此，在本综述中，我们重点讨论了这些问题，以强调减少和预防TA后HCC复发和进展的潜在有效策略。

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引用次数: 0