ABSTRACT
Context: Radiofrequency ablation (RFA), an established and minimally invasive therapy for hepatocellular carcinoma, has become an important treatment strategy. However, tumor aggressiveness remains a common problem. The epithelial–mesenchymal transition (EMT) is thought to play an important role in this process. Design and Aims: Due to limited sample volumes harvested from patients, we established a heat-treated cell line and a mouse model to investigate the mechanisms of incomplete ablation in EMT. Materials and Methods: We heat-treated H22 and HepG2 cells using a water bath to determine a suitable temperature for incomplete RFA. Male BALB/c mice were orthotopically transplanted with H22 cells and then subjected to incomplete ablation. Changes in the EMT biomarkers were detected by real-time polymerase chain reaction, western blotting, and immunofluorescence. Statistical Analysis: The experimental results are expressed as means ± standard deviations. Results: Incomplete RFA promoted EMT, downregulated E-cadherin, upregulated vimentin and Snail, and enhanced the phosphorylation of signal transducer and activator of transcription 3 (STAT3) both in vivo and in vitro. Moreover, interleukin (IL)-6 secretion increased after heat treatment in the H22 cells. AG490, an IL-6 inhibitor, inhibited the occurrence of EMT. Conclusions: Insufficient ablation performed at low temperature successfully induces EMT and promotes tumor aggressiveness, which is mediated by the IL-6/STAT3/Snail pathway in both cell and mouse models.
ABSTRACT
Aims: We aimed to investigate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) combined with percutaneous vertebroplasty (PVP) for treating VX2 vertebral metastases with posterior margin destruction in a rabbit model. Materials and Methods: Sixty rabbit models of VX2 vertebral metastases with posterior margin destruction were constructed through computed tomography (CT)-guided percutaneous puncture and randomly divided into four groups of 15 rabbits each: Groups A, RFA+PVP; B, PVP; C, RFA; and D, control. Five rabbits in each group were sacrificed within 24 h of the procedure. Pathological examination and immunohistochemical staining revealed the presence of a biomembrane barrier at the tumor edge; furthermore, bone cement leakage into the spinal canal was observed. The survival time of the remaining rabbits per group was observed, and the differences were analyzed. Results: CT scans of Group A and C rabbits revealed a low-density band around the tumor ablation region. Bone cement leakage rate significantly differed between Groups A and B (20% vs. 100%; P < 0.05). The average postoperative survival times of Group A, B, C, and D rabbits were 16.72 ± 0.93, 7.26 ± 0.75, 7.80 ± 1.30, and 3.84 ± 1.24 days, respectively, showing a significant difference between Group A and the remaining groups (P < 0.05). Conclusions: The biomembrane barrier formed at the tumor edge after RFA can prevent bone cement leakage into the spinal canal, reducing spinal cord injury and prolonging the survival time
ABSTRACT
Purpose: This study aimed to retrospectively assess the outcome of interstitial iodine-125 brachytherapy for unresectable hepatocellular carcinoma (HCC). Materials and Methods: Between February 2013 and March 2019, 57 patients with 108 unresectable HCC lesions treated with computed tomography (CT)-guided iodine-125 seed brachytherapy were retrospectively analyzed. The primary endpoint was overall survival (OS). The secondary endpoints included local tumor control and progression-free survival (PFS). Potential factors associated with OS were assessed. Results: The mean follow-up duration was 24.3 ± 15.6 months (median, 20.5 months; range, 3.9–66.8 months). The median OS time was 23.6 months (95% confidence interval [CI], 18.4–28.8 months). The 1-, 2-, and 3-year actuarial OS rates were 80.0%, 46.1%, and 24.3%, respectively. The median PFS time was 12 months (95% CI, 9.9–14.5 months). The 1- and 2-year actuarial PFS rates were 50% and 20.1%, respectively. Local progression was noted in 11 (11.3%) of 108 lesions with mean local control time of 20.5 ± 8.8 months. The 1- and 2-year local control rates were 96.5% and 88.8%, respectively. Barcelona clinic liver cancer stage and Child–Pugh score were independent risk factors affecting the prognosis (hazard ratio [HR] = 0.330 [95% CI, 0.128–0.853] and HR = 0.303 [95% CI, 0.151–0.610], respectively). Hepatic artery pseudoaneurysm was found in 1 (1.8%) patient with lesion located in the porta hepatis. No other major complications developed during follow-up. Conclusion: CT-guided iodine-125 brachytherapy may be an effective and safe alternative with promising survival and increased local control rate in unresectable HCC treatment