ABSTRACT
In recent years, the incidence of renal cancer has been increasing continuously. Surgical resection is the "gold standard" for the treatment of small renal cancer. However, local ablation therapy of renal cancer is undoubtedly the best choice for patients with short life expectancy, other complications, and impaired renal function who are not suitable for surgery. In recent years, with the development of ablation techniques and long-term follow-up, local ablation has shown good therapeutic effects. As many domestic hospitals are performing or planning to perform renal tumor cryoablation to improve the clinical cure rate and surgical safety of renal tumor cryoablation, it is necessary to standardize the surgical indications, contraindications, perioperative management, efficacy evaluation, and other common problems. Currently, there is no expert consensus regarding perioperative renal tumor cryoablation in China. To standardize the perioperative management of renal tumor cryoablation and related technical operations in clinical practice, and improve the effectiveness and safety of cryoablation, the expert committee of Tumor Interventional and Minimally Invasive Diagnosis and Treatment Continuing Education Base of the Chinese Anti-Cancer Association convened experts in related fields to discuss and formulate this consensus, which is hereby published, for clinical reference and application.
Subject(s)
Humans , Carcinoma, Renal Cell/surgery , Consensus , Cryosurgery/methods , Kidney Neoplasms/pathology , Treatment Outcome , ChinaABSTRACT
Objective To investigate the influence of neutrophil-to-lymphocyte ratio (NLR) in peripheral blood in patients with hepatocellular carcinoma (HCC) before argon-helium cryoablation on the patient's prognosis.Methods The related clinical and pathological data of 72 HCC patients,who had received percutaneous argon-helium cryoablation,were retrospectively analyzed.Based on the preoperative NLR value,the patients were divided into low NLR group (NLR＜3.5) and high NLR group (NLR ＞ 3.5).The postoperative overall survival time of the patients in the two groups were statistically analyzed,and the risk factors that might affect the prognosis were evaluated by using univariate and multivariate analysis.Results Argon-helium cryoablation was carried out in all patients.The median overall survival time was 22.4 months;the median overall survival time of the high NLR group and the low NLR group was 13.2 months and 24.2 months respectively,the difference in the overall survival time between the two groups was statistically significant (P=0.003).Univariate analysis showed that the primary tumor size,liver function Child-Pugh classification,albumin,total bilirubin,cholinesterase and NLR value were the related factors that affected the postoperative overall survival time of HCC after argon-helium cryoablation (P＜0.05).Multivariate analysis revealed that the primary tumor size and NLR value were the independent prognostic factors that affected the postoperative overall survival time of HCC after argon-helium cryoablation (P＜0.05).Conclusion Preoperative NLR value in peripheral blood can be used as a prognostic indicator for patients with HCC undergoing argonhelium cryoablation;the larger the primary hepatic lesion is and/or the higher the NLR value is,the worse the prognosis of the patient will be.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the anti-tumor immune response to percutaneous cryoablation in patients with local prostate cancer.</p><p><b>METHODS</b>We treated 10 patients with local prostate cancer by percutaneous cryoablation, collected the blood samples before and 2 weeks after the treatment and isolated peripheral blood mononuclear cells (PBMCs). Protein lysates were made by biopsy from autologous prostate cancer or non-cancer tissues. The levels of serum TNF-alpha, IFN-gamma, IL4 and IL-10 were determined by enzyme-linked immunosorbent assay (ELISA) and the Th1/Th2 ratio was calculated by the IFN-gamma/IL-4 ratio. The number of IFN-gamma + T cells under the stimulation of different protein lysates was counted by enzyme link immunol spot (ELISPOT). And the cytolytic activity of cytotoxic T lymphocytes (CTL) was detected by LDH assay.</p><p><b>RESULTS</b>Compared with pre-treatment, the levels of TNF-alpha and IFN-gamma, the Th1/ Th2 ratio and the number of IFN-gamma + T cells induced by tumor protein lysates in PBMCs were increased significantly after cryosurgery (P < 0.01), while the levels of IL4 and IL-10 decreased slightly, and the non-tumor protein lysates induced no obvious changes in the number of IFN-gamma T cells. The cytolytic activity of cytotoxic T lymphocytes against human prostate cancer cells LNCaP was markedly increased, but not that against renal cancer cells GRC-1. One case of recurrence was found during the 3-6 months follow-up.</p><p><b>CONCLUSION</b>Percutaneous cryoablation for prostate cancer could induce a tumor-specific immune response.</p>