Immune response triggered by the ablation of hepatocellular carcinoma with nanosecond pulsed electric field
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REVIEW
Immune response triggered by the ablation of hepatocellular carcinoma with nanosecond pulsed electric field Jianpeng Liu, Xinhua Chen, Shusen Zheng (
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Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, Key Laboratory of Organ Transplantation, Hangzhou 310003, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China
© Higher Education Press 2020
Abstract Nanosecond pulsed electric field (nsPEF) is a novel, nonthermal, and minimally invasive modality that can ablate solid tumors by inducing apoptosis. Recent animal experiments show that nsPEF can induce the immunogenic cell death of hepatocellular carcinoma (HCC) and stimulate the host’s immune response to kill residual tumor cells and decrease distant metastatic tumors. nsPEF-induced immunity is of great clinical importance because the nonthermal ablation may enhance the immune memory, which can prevent HCC recurrence and metastasis. This review summarized the most advanced research on the effect of nsPEF. The possible mechanisms of how locoregional nsPEF ablation enhances the systemic anticancer immune responses were illustrated. nsPEF stimulates the host immune system to boost stimulation and prevail suppression. Also, nsPEF increases the dendritic cell loading and inhibits the regulatory responses, thereby improving immune stimulation and limiting immunosuppression in HCC-bearing hosts. Therefore, nsPEF has excellent potential for HCC treatment. Keywords metastasis
nanosecond pulsed electric fields (nsPEF); hepatocellular carcinoma (HCC); immune response; recurrence;
Introduction Hepatocellular carcinoma (HCC) is one of the most common and deadly malignant tumors in the world [1]. Resection and liver transplantation are still effective methods for early HCC treatment [2,3]. However, most liver cancers are diagnosed at an advanced stage, and only approximately 20% of these patients have the chance to undergo surgery. In addition, the postoperative recurrence rates of HCC are still high, requiring multiple treatments to prolong the life of patients. Therefore, finding novel therapies that can be applied repeatedly and are minimally invasive for HCC patients is important. With the development of minimally invasive technologies, an increasing number of local ablation methodologies are being applied in the treatment of HCC. Most of them are thermal ablative techniques such as cryoablation,
Received June 21, 2019; accepted December 18, 2019 Correspondence: Shusen Zheng, [email protected]
radiofrequency ablation (RFA), microwave ablation (MWA) [4], and focused ultrasound [5]. Notably, RFA has become the mostly widely used local ablation treatment in the clinic. Two randomized controlled studies between surgical resection and RFA h
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