免疫治疗肝细胞癌的文献计量学研究。

BACKGROUND: Hepatocellular carcinoma (HCC), recognized as a significant global health concern, ranks as the sixth most prevalent form of cancer and is the third leading cause of cancer-associated mortality. Over half of HCC patients are diagnosed at advanced stages, an unfortunate phenomenon primarily attributed to the liver's robust compensatory mechanisms. Given the limited availability of donor livers, existing clinical surgical approaches have yet to provide universally applicable treatment strategies offering substantial prognostic improvement for late-stage cancer. Although the past few decades have witnessed significant advancements in chemotherapy and targeted therapy for HCC, the emergence of drug resistance poses a substantial impediment to their successful execution. Furthermore, issues such as diminished quality of life post-treatment and high treatment costs warrant critical attention. Consequently, the imperative for an effective treatment strategy for advanced liver cancer is unequivocal. In recent years, notable progress in the development and application of immunotherapy has sparked a revolution in advanced liver cancer treatment. This study aims to elucidate a more comprehensive understanding of the current landscape, knowledge framework, research focal points, and nascent breakthrough trends in the domain of immunotherapy for hepatocellular carcinoma via bibliometric analysis. METHOD: Our study involved conducting a comprehensive literature search spanning from 1999 through December 31, 2022, by utilizing the Science Citation Index Expanded (SCI-Expanded) database. Our aim was to amass all the papers and reviews related to immunotherapy for hepatocellular carcinoma. Our search strategy yielded a total of 4,486 papers. After exclusion of self-citations, we focused our analysis on 68,925 references. These references were cited 119,523 times (excluding 97,941 self-citations), boasting an average citation frequency of 26.64 times per paper, and achieved an h-index of 135. We employed analytical software tools like Citespace and VOSviewer to perform an intricate analysis of the amassed literature, covering various aspects, including geographical location, research institutions, publishing journals, authors, references, and keywords. Our method incorporated timeline analysis, burst detection, and co-occurrence analysis. The application of these tools facilitated a thorough evaluation of research hotspots, knowledge structure, and emerging advancements within the sphere of immunotherapy for hepatocellular carcinoma. RESULTS: Our bibliometric analysis disclosed a noteworthy escalation in the number of publications in the realm of hepatocellular carcinoma immunotherapy during the years 2021-2022, surpassing the aggregate number of papers published in the preceding decade (2011-2020). This surge underscores a sharp upturn in research interest within this field. Additionally, the research hotspot in hepatocellular carcinoma immunotherapy has perceptibly deviated from the preceding decade's trends. In terms of geographical distribution, China emerged as the leading country, producing 50.08% of the total publications. This was followed by the United States, with 963 papers, and Japan, contributing 335 papers. Among research institutions, Sun Yat-sen University was the most prolific, while Tim F. Greten stood out as the most published author with 42 papers to his credit. A co-reference network examination uncovered a shift in research emphasis within the field of hepatocellular carcinoma immunotherapy, highlighting the evolving nature of this important area of study. CONCLUSION: Our bibliometric study highlights the significant evolution and growth in HCC immunotherapy research over the past two decades. Looking ahead, research will focus on improving the microenvironment post-drug resistance from immune combination therapy, harnessing adoptive cellular immunity (as CAR-T), subclassify the population and developing new tumor markers. Incorporation of technologies such as nanotechnology, microbiology, and gene editing will further advance HCC treatments. This progressive trajectory in the field promises a brighter future for individuals suffering from HCC.

背景：肝细胞癌（HCC）作为一个全球性的健康问题，是第六大常见癌症，也是癌症相关死亡的第三大主要原因。超过一半的 HCC 患者在晚期被诊断出来，这种不幸的现象主要归因于肝脏强大的代偿机制。由于供体肝脏的有限可用性，现有的临床手术方法尚未为晚期癌症提供普遍适用的治疗策略，从而显著改善预后。尽管过去几十年 HCC 的化疗和靶向治疗取得了显著进展，但药物耐药性的出现对其成功实施构成了重大障碍。此外，治疗后生活质量下降和治疗费用高的问题也需要引起关注。因此，对于晚期肝癌来说，制定有效的治疗策略是当务之急。近年来，免疫治疗的发展和应用取得了显著进展，为晚期肝癌的治疗带来了一场革命。本研究旨在通过文献计量分析，阐明 HCC 免疫治疗领域的现状、知识框架、研究重点和新兴突破趋势。

方法：我们的研究涉及从 1999 年到 2022 年 12 月 31 日，使用科学引文索引扩展版（SCI-Expanded）数据库进行全面的文献搜索。我们的目的是收集所有与 HCC 免疫治疗相关的论文和综述。我们的搜索策略共产生了 4486 篇论文。在排除自引后，我们将分析重点放在 68925 篇参考文献上。这些参考文献被引用了 119523 次（不包括 97941 次自引），平均每篇论文被引用 26.64 次，h 指数为 135。我们使用 Citespace 和 VOSviewer 等分析软件工具对收集的文献进行深入分析，涵盖地理位置、研究机构、出版期刊、作者、参考文献和关键词等各个方面。我们的方法包括时间线分析、突发检测和共现分析。这些工具的应用有助于全面评估 HCC 免疫治疗领域的研究热点、知识结构和新兴进展。

结果：我们的文献计量分析显示，HCC 免疫治疗领域的出版物数量在 2021-2022 年期间显著增加，超过了前十年（2011-2020 年）的总和。这表明该领域的研究兴趣急剧上升。此外，HCC 免疫治疗的研究热点明显偏离了前十年的趋势。在地理位置方面，中国是领先的国家，发表了 50.08%的总论文。其次是美国，有 963 篇论文，日本有 335 篇论文。在研究机构方面，中山大学是最有影响力的机构，而 Tim F. Greten 则是最有影响力的作者，有 42 篇论文。共被引网络分析揭示了 HCC 免疫治疗领域研究重点的转变，突出了该重要研究领域的演变性质。

结论：我们的文献计量研究强调了过去二十年 HCC 免疫治疗研究的显著发展和增长。展望未来，研究将集中于改善药物耐药后免疫联合治疗的微环境，利用过继细胞免疫（如 CAR-T）、对人群进行分类和开发新的肿瘤标志物。纳米技术、微生物学和基因编辑等技术的结合将进一步推进 HCC 的治疗。该领域的这一进展轨迹为 HCC 患者带来了更美好的未来。