De Re Valli, Rossetto Anna, Rosignoli Alessandro, Muraro Elena, Racanelli Vito, Tornesello Maria Lina, Zompicchiatti Aron, Uzzau Alessandro
Immunopatologia e Biomarcatori Oncologici/Bio-proteomics Facility, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
General Surgery, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), San Daniele del Friuli, Udine, Italy.
Front Oncol. 2022 Jul 7;12:897703. doi: 10.3389/fonc.2022.897703. eCollection 2022.
Ablative and locoregional treatment options, such as radiofrequency, ethanol injection, microwave, and cryoablation, as well as irreversible electroporation, are effective therapies for early-stage hepatocellular carcinoma (HCC). Hepatocyte death caused by ablative procedures is known to increase the release of tumor-associated antigen, thus enhancing tumor immunogenicity. In addition, the heat ablative resection induces pyroptotic cell death accompanied by the release of several inflammatory factors and immune-related proteins, including damage-associated molecular patterns (DAMPs), heat shock proteins (HSPs), ficolin 3, ATP, and DNA/RNA, which potentiate the antitumoral immune response. Surgical approaches that enhance tumor necrosis and reduce hypoxia in the residual liver parenchyma have been shown to increase the disease-free survival rate by reducing the host's immunosuppressive response. Scalpel devices and targeted surgical approach combined with immune-modulating drugs are an interesting and promising area to maximize therapeutic outcomes after HCC ablation.
诸如射频、乙醇注射、微波、冷冻消融以及不可逆电穿孔等消融和局部区域治疗方案，是早期肝细胞癌（HCC）的有效治疗方法。已知消融手术导致的肝细胞死亡会增加肿瘤相关抗原的释放，从而增强肿瘤免疫原性。此外，热消融切除诱导细胞焦亡，伴随着多种炎症因子和免疫相关蛋白的释放，包括损伤相关分子模式（DAMPs）、热休克蛋白（HSPs）、纤维胶凝蛋白3、ATP以及DNA/RNA，这些物质会增强抗肿瘤免疫反应。已表明，能够增强肿瘤坏死并减少残余肝实质缺氧的手术方法，可通过降低宿主的免疫抑制反应来提高无病生存率。手术刀设备以及与免疫调节药物相结合的靶向手术方法，是使HCC消融后治疗效果最大化的一个有趣且有前景的领域。
