Xie Gui-Lin, Zhong Zhi-Han, Ye Tai-Wei, Xiao Zun-Qiang
Department of Hepatobiliary Surgery, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, China.
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
BMC Surg. 2025 Jan 29;25(1):47. doi: 10.1186/s12893-025-02778-z.
Hepatocellular carcinoma (HCC) is a highly immunogenic tumor and the third leading cause of cancer-related deaths worldwide with an increasing incidence. Therefore, the combination of immunotherapy with other approaches, such as anti-angiogenic agents and local area therapy, has become a new strategy for HCC treatment.
We searched PubMed and Web of Science and extracted publications relating to the radiofrequency ablation (RFA) and immunotherapy. The search terms were: "radiofrequency ablation", "immunotherapy" and "hepatocellular carcinoma", and manual searches of eligible articles from literature reference lists were performed. We then thoroughly reviewed the literature on ablation combined with immunotherapy for HCC, analyzed the relevant mechanism, and explored the safety and effectiveness of this form of combination therapy.
RFA combined with immunotherapy in HCC is reported to have good efficacy and controllable safety. On the one hand, RFA can induce the immunogenic substances including Ficolin-3, IL-1 and heat shock protein and regulate the immune cells by mediating the Th1/Th2 ratio, increasing Th17 cells, etc. On the other hand, RFA treatment can lead to tumor immune microenvironment reconstruction, increasing the proportion of functional T cells and upregulate PD-1 in T cells in distant tumors without RFA. This combined strategy has the ability to enhance the anti-tumor immune response through synergies, significantly reduce the risk of recurrence and improve survival.
RFA combined with immunotherapy yields a good synergistic effect: it can further strengthen anti-tumor response, delay distant tumor growth, reduce tumor recurrence and metastasis, providing new options for HCC systemic treatment.
肝细胞癌（HCC）是一种具有高度免疫原性的肿瘤，是全球癌症相关死亡的第三大主要原因，且发病率不断上升。因此，免疫疗法与其他方法（如抗血管生成药物和局部治疗）的联合已成为HCC治疗的新策略。
我们检索了PubMed和Web of Science，并提取了与射频消融（RFA）和免疫疗法相关的出版物。检索词为：“射频消融”、“免疫疗法”和“肝细胞癌”，并对符合条件文章的文献参考文献列表进行了人工检索。然后，我们全面回顾了关于HCC消融联合免疫疗法的文献，分析了相关机制，并探讨了这种联合治疗形式的安全性和有效性。
据报道，RFA联合免疫疗法治疗HCC具有良好的疗效和可控的安全性。一方面，RFA可诱导包括纤维胶凝蛋白-3、白细胞介素-1和热休克蛋白在内的免疫原性物质，并通过调节Th1/Th2比值、增加Th17细胞等方式调节免疫细胞。另一方面，RFA治疗可导致肿瘤免疫微环境重建，增加功能性T细胞比例，并上调未接受RFA的远处肿瘤中T细胞的程序性死亡受体1（PD-1）。这种联合策略有能力通过协同作用增强抗肿瘤免疫反应，显著降低复发风险并提高生存率。
RFA联合免疫疗法产生良好的协同效应：它可进一步增强抗肿瘤反应，延缓远处肿瘤生长，减少肿瘤复发和转移，为HCC的全身治疗提供新的选择。
