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超声造影特征在诊断肝细胞癌免疫治疗后假性进展中的应用：1例假性进展后反应的病例报告

Contrast-enhanced Ultrasonography Features for Diagnosing Pseudoprogression of Hepatocellular Carcinoma with Immunotherapy: A Case Report of the Response after Pseudoprogression.

作者信息

Otake Shin, Ota Yu, Aso Kazunobu, Okada Mitsuyoshi, Hayashi Hidemi, Hasebe Takumu, Nakajima Shunsuke, Sawada Koji, Fujiya Mikihiro, Okumura Toshikatsu

机构信息

Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan.

Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan.

出版信息

Intern Med. 2024 Apr 15;63(8):1093-1097. doi: 10.2169/internalmedicine.2349-23. Epub 2023 Sep 1.

DOI:10.2169/internalmedicine.2349-23
PMID:37661447
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11081889/
Abstract

A male patient in his 70s with recurrent hepatocellular carcinoma (HCC) after surgery received atezolizumab plus bevacizumab (Atezo+Bev) therapy. Initial computed tomography (CT) revealed tumor growth along with an increase in tumor markers, and contrast-enhanced ultrasonography (CEUS) showed multiple round avascular areas within the nodules with an appearance similar to a slice of Swiss cheese. Continuation of immunotherapy with consideration of the potential for pseudoprogression produced a dramatic response. Although it is difficult to distinguish between true progression and pseudoprogression, the Swiss cheese-like appearance on CEUS may be important for the early diagnosis of pseudoprogression.

摘要

一名70多岁的男性患者，术后复发性肝细胞癌（HCC），接受了阿替利珠单抗联合贝伐单抗（阿替利珠单抗+贝伐单抗）治疗。初始计算机断层扫描（CT）显示肿瘤生长并伴有肿瘤标志物升高，对比增强超声（CEUS）显示结节内有多个圆形无血管区域，外观类似瑞士奶酪切片。考虑到假性进展的可能性继续进行免疫治疗产生了显著反应。虽然很难区分真正的进展和假性进展，但CEUS上类似瑞士奶酪的表现可能对假性进展的早期诊断很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11081889/9599ca8c522e/1349-7235-63-1093-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11081889/6a396af31ba0/1349-7235-63-1093-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11081889/9599ca8c522e/1349-7235-63-1093-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11081889/6a396af31ba0/1349-7235-63-1093-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6112/11081889/9599ca8c522e/1349-7235-63-1093-g002.jpg

相似文献

[1]
Contrast-enhanced Ultrasonography Features for Diagnosing Pseudoprogression of Hepatocellular Carcinoma with Immunotherapy: A Case Report of the Response after Pseudoprogression.

Intern Med. 2024-4-15

[2]
A case of hepatocellular carcinoma with "pseudoprogression" followed by complete response to atezolizumab plus bevacizumab.

Clin J Gastroenterol. 2023-6

[3]
Evaluation of atezolizumab plus bevacizumab combination therapy for hepatocellular carcinoma using contrast-enhanced ultrasonography.

J Med Ultrason (2001). 2023-1

[4]
The usefulness of contrast-enhanced ultrasonography in the early detection of hepatocellular carcinoma viability after transarterial chemoembolization: pilot study.

Clin Mol Hepatol. 2015-6

[5]
Hepatocellular Carcinoma Pseudoprogression Involving the Main Portal Vein, Right Ventricular Invasion, and Exacerbation of Lung Metastases in a Patient on Atezolizumab Plus Bevacizumab.

Intern Med. 2023-2-15

[6]
Transarterial Chemoembolization of HCC with Radiopaque Microspheres: Evaluation with Computed Tomography and the Complementary Role of Contrast-Enhanced Ultrasonography.

Cardiovasc Intervent Radiol. 2020-5-11

[7]
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Clin Hemorheol Microcirc. 2010

[8]
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Biomed Res Int. 2018-11-7

[9]
Imaging of intrahepatic progression of hepatocellular carcinoma post transarterial chemoembolization. A long-term, prospective evaluation of contrast-enhanced ultrasonography (CEUS).

Med Ultrason. 2017-4-22

[10]
Contrast-Enhanced Ultrasonography Versus Contrast-Enhanced Computed Tomography for Assessment of Residual Tumor From Hepatocellular Carcinoma Treated With Transarterial Chemoembolization: A Meta-analysis.

J Ultrasound Med. 2018-8

引用本文的文献

[1]
Pseudoprogression in Hepatocellular Carcinoma During Atezolizumab Plus Bevacizumab Therapy: A Case Report and a Review of Literature.

Cureus. 2025-6-28

[2]
Comparing health insurance-reimbursed lenvatinib and self-paid atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma.

Am J Cancer Res. 2025-2-15

[3]
Noninvasive Visualization of Tumor Blood Vessels within Hepatocellular Carcinoma by Application of Superb Microvascular Imaging to Contrast-Enhanced Ultrasonography.

Diagnostics (Basel). 2024-3-23

[4]
Systemic therapies in hepatocellular carcinoma: A revolution?

United European Gastroenterol J. 2024-3

本文引用的文献

[1]
A case of hepatocellular carcinoma with "pseudoprogression" followed by complete response to atezolizumab plus bevacizumab.

Clin J Gastroenterol. 2023-6

[2]
Contrast-enhanced ultrasonography for the diagnosis of spontaneous necrosis of hepatocellular carcinoma: A report of 2 cases.

Radiol Case Rep. 2022-11-1

[3]
Durvalumab plus tremelimumab in unresectable hepatocellular carcinoma.

Hepatobiliary Surg Nutr. 2022-8

[4]
Hepatocellular Carcinoma Pseudoprogression Involving the Main Portal Vein, Right Ventricular Invasion, and Exacerbation of Lung Metastases in a Patient on Atezolizumab Plus Bevacizumab.

Intern Med. 2023-2-15

[5]
Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma.

J Hepatol. 2022-4

[6]
A Case of Pseudoprogression in Hepatocellular Carcinoma Treated With Atezolizumab Plus Bevacizumab.

J Investig Med High Impact Case Rep. 2021

[7]
BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update.

J Hepatol. 2022-3

[8]
Immune response evaluation criteria in solid tumors for assessment of atypical responses after immunotherapy.

World J Clin Oncol. 2021-5-24

[9]
A Changing Paradigm for the Treatment of Intermediate-Stage Hepatocellular Carcinoma: Asia-Pacific Primary Liver Cancer Expert Consensus Statements.

Liver Cancer. 2020-6

[10]
Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma.

N Engl J Med. 2020-5-14

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