[Study on the significance of intravoxel incoherent motion quantitative index combined with time-signal intensity curve in the early diagnosis of residual lesions in non-small cell lung cancer after argon-helium cryosurgery].

Objective: To study the application of intravoxel incoherent motion (IVIM) quantitative index combined with time-signal intensity curve (TIC) of dynamic contrast enhanced 3.0T magnetic resonance in the early precise diagnosis of residual lesions in non-small cell lung cancer (NSCLC) after argon-helium cryosurgery. Methods: One hundred NSCLC patients who underwent argon-helium cryosurgery were collected and divided into the residual group (21 cases) and non-residual group (79 cases) according to the result of needle biopsy and follow-up. The apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (sADC), fast apparent diffusion coefficient (fADC), fraction of fast apparent diffusion coefficient (ffADC) and TIC type of IVIM quantitative index between the two groups were compared at 7 days and 1 month after argon-helium cryosurgery, respectively. The diagnosis performance of each quantitative index was analyzed by receiver operating characteristic (ROC) curve and the best cut-off value was computed. The specificity and sensitivity of TIC types were calculated as diagnostic criteria. The diagnosis performance of IVIM quantitative index combined with TIC type was evaluated and compared with the conventional MRI and DWI. Results: The differences of ADC, sADC and ffADC at 7 days and 1 month after argon-helium cryosurgery between the residual group and non-residual group were statistically significant (all P<0.05), in which the diagnosis performance of sADC and ffADC were better. The AUC of sADC and ffADC at 7 days after argon-helium cryosurgery were 0.861 and 0.895, the sensitivity were 81.0% and 90.5%, and the specificity were 77.2% and 73.4%, respectively. The AUC of sADC and ffADC at 1 month after argon-helium cryosurgery were 0.836 and 0.883, the sensitivity were 100.0% and 76.2%, and the specificity were 58.2% and 89.9%, respectively. The diagnosis performance of TIC type Ⅱ&Ⅲ was best. The sensitivity and specificity were 80.9% and 58.2% at 7 days after treatment, 85.7% and 62.0% at 1 month after treatment, respectively. At 7 days after treatment, the sensitivity and specificity of IVIM combined with TIC were 97.5% and 85.7%, while at 1 month after treatment, the sensitivity and specificity of IVIM combined with TIC were 97.5% and 90.5%, respectively. The diagnosis performance of IVIM quantitative index combined with TIC type was better than conventional MRI and DWI. Conclusion: The combination of IVIM quantitative index and TIC type can be used in the early diagnosis of residual lesions after argon-helium cryosurgery for NSCLC, whose effect is better than conventional MRI and DWI.

Study on the significance of intravoxel incoherent motion quantitative index combined with time-signal intensity curve in the early diagnosis of residual lesions in non-small cell lung cancer after argon-helium cryosurgery / 中华肿瘤杂志

Objective@#To study the application of intravoxel incoherent motion (IVIM) quantitative index combined with time-signal intensity curve (TIC) of dynamic contrast enhanced 3.0T magnetic resonance in the early precise diagnosis of residual lesions in non-small cell lung cancer (NSCLC) after argon-helium cryosurgery.@*Methods@#One hundred NSCLC patients who underwent argon-helium cryosurgery were collected and divided into the residual group (21 cases) and non-residual group (79 cases) according to the result of needle biopsy and follow-up. The apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (sADC), fast apparent diffusion coefficient (fADC), fraction of fast apparent diffusion coefficient (ffADC) and TIC type of IVIM quantitative index between the two groups were compared at 7 days and 1 month after argon-helium cryosurgery, respectively. The diagnosis performance of each quantitative index was analyzed by receiver operating characteristic (ROC) curve and the best cut-off value was computed. The specificity and sensitivity of TIC types were calculated as diagnostic criteria. The diagnosis performance of IVIM quantitative index combined with TIC type was evaluated and compared with the conventional MRI and DWI.@*Results@#The differences of ADC, sADC and ffADC at 7 days and 1 month after argon-helium cryosurgery between the residual group and non-residual group were statistically significant (all P<0.05), in which the diagnosis performance of sADC and ffADC were better. The AUC of sADC and ffADC at 7 days after argon-helium cryosurgery were 0.861 and 0.895, the sensitivity were 81.0% and 90.5%, and the specificity were 77.2% and 73.4%, respectively. The AUC of sADC and ffADC at 1 month after argon-helium cryosurgery were 0.836 and 0.883, the sensitivity were 100.0% and 76.2%, and the specificity were 58.2% and 89.9%, respectively. The diagnosis performance of TIC type Ⅱ&Ⅲ was best. The sensitivity and specificity were 80.9% and 58.2% at 7 days after treatment, 85.7% and 62.0% at 1 month after treatment, respectively. At 7 days after treatment, the sensitivity and specificity of IVIM combined with TIC were 97.5% and 85.7%, while at 1 month after treatment, the sensitivity and specificity of IVIM combined with TIC were 97.5% and 90.5%, respectively. The diagnosis performance of IVIM quantitative index combined with TIC type was better than conventional MRI and DWI.@*Conclusion@#The combination of IVIM quantitative index and TIC type can be used in the early diagnosis of residual lesions after argon-helium cryosurgery for NSCLC, whose effect is better than conventional MRI and DWI.

Functional Changes of Dendritic Cells in C6 Glioma-Bearing Rats That Underwent Combined Argon-Helium Cryotherapy and IL-12 Treatment.

OBJECTIVE: The aim of this study was to explore changes in tumor tissues of glioma-bearing rats that underwent argon-helium cryoablation as well as changes in antitumor immunity before and after combined interleukin 12 treatment. METHODS: Two hundred sixty Wistar rats were randomly divided into a blank control group, intravenous injection interleukin-12 group, cryotherapy group, and cryotherapy + intravenous injection group. C6 glioma cells proliferated in vitro were implanted subcutaneously on the backs of rats to establish C6 glioma-bearing animal models. Each group underwent the corresponding treatments, and morphological changes in tumor tissues were examined using hematoxylin-eosin staining. CD11c staining was examined using immunohistochemistry, and differences in dendritic cells and T-cell subsets before and after treatment were analyzed using flow cytometry. RESULTS: The control group showed no statistical changes in terms of tumor tissue morphology and cellular immunity, cryotherapy group, and cryotherapy + intravenous injection group, among which the count for the cryotherapy + intravenous injection group was significantly higher than those of all other groups. In the argon-helium cryotherapy group, tumor cells were damaged and dendritic cell markers were positive. The number of CD11c+ and CD86+ cells increased significantly after the operation as did the cytokine interferon-γ level (P < .01), suggesting a shift toward Th1-type immunity. CONCLUSION: Combined treatment of argon-helium cryoablation and interleukin 12 for gliomas not only effectively injured tumor tissues but also boosted immune function and increased antitumor ability. Therefore, this approach is a promising treatment measure for brain gliomas.

Status and prospect of argon-helium cryosurgery system for the treatment of gliomas / 中国肿瘤临床

Glioma is one of the most refractory tumors affecting the central nervous system. As a new technique, cryoablation has been considered for the treatment of glioma. Considering previous studies, we summarized the mechanism of cryoablation to treat glioma based on pathology and molecular biology perspectives. We also analyzed the indications, effects, and problems of cryoablation in clinical practice. Furthermore, we proposed that this technique may be used in future trends and applications. The mechanism of eradicating tumor cells by cryoablation involves the following:(1) using an ultralow temperature to induce necrosis and apoptosis;(2) changing the local microcirculation of tumors;and (3) adjusting anti-tumor immunity. As an alternative surgical treatment, cryoablation could improve the therapeutic effects by real-time medical imaging. Cryoablation combined with chemotherapy, radiotherapy, immunotherapy, and other methods could provide a more effective treatment for gliomas. Therefore, cryotherapy could be a possible treatment for glioma and become a sustained research field.

Effect of Argon-Helium Cryosurgery on Regulatory T Lymphocytes in the Peripheral Blood of Patients with Advanced Renal Carcinoma / 中国肿瘤临床

Objective: To analyze the effect of Argon-Helium cryosurgery (AHCS) on CD4+ CD25+ regulatory T cells (Treg) and its implication in patients with advanced renal carcinoma.Methods:,Peripheral venous blood samples were ob-tained from 32 patients with advanced renal cell carcinoma before and after AHCS.The proportions of Treg cells and T lym-phocyte subsets (CD3+ T, CD4+ T, CD8+ T, CD4+ T/CD8+ T, and NK cells) in the peripheral blood were measured by flow cytometry.Enhanced CT or enhanced MRI was used to observe the necrosis of tumor at 1 month after AHCS.The areas with no imaging enhancement in tumor were regarded as tumor necrosis.The necrosis rate was measured by Cavalieri method and the tumor burden was evaluated.Results: At 3 months after AHCS, the percentages of Treg cells were gradual-ly decreased from 4.18%±1.58% to 1.96%±0.54%, with a significant difference (P=0.001).At 3 months after AHCS, the pro-portions of CD3+ T, CD4+ T, NK and CD4+ T/CD8+ T were gradually increased from 19.26%±7.52%, 43.54%±12.99%, 1.15%±0.57%, and 17.49%±8.36% to 30.83%±5.69%, 49.58±10.76%, 1.84%±0.12%, and 27.63%±8.20%, with a statistical significance (P=0.000, P=0.003, P=0.02, and P=0.001).The proportion of CD8 + T was decreased from 40.86%±8.89% to the lowest ratio (26.74%±4.29%) at 3 months after AHCS, with a significant difference (P=0.000).At 3～6 months after cryo-therapy, there was only a slight change in the proportions of CD3 + T, CD4 + T, CD4 + T/CD8 + T, NK, CD8 + T, and Treg cells, with no significant difference (P>0.05).Correlation analysis showed that the decrease in tumor burden was positively correlated with the decrease of the proportion of Treg cells (r=0.793, P<0.01).Conclusion: After AHCS, the distribution of T-lymphocyte subsets can be improved and the anti-tumor immune response was strengthened.The percentage of Treg cells is correlated with tumor burden.