肝细胞癌生物免疫治疗的影像学评价现状

Imaging evaluation of immunotherapy for hepatocellular carcinoma

目的分析并总结现有影像学技术在评估免疫治疗肝细胞癌疗效的优缺点和局限性,以期为肝细胞癌患者药物治疗评价和临床决策提供有力证据。方法查阅国内外有关肝细胞癌生物免疫治疗影像学评价的相关文献,分析并总结不同影像学技术评价肝细胞癌免疫治疗的价值。结果免疫治疗具有无创、特异度高、疗效好等特点,在近几年的肝细胞癌治疗领域占据了重要地位。目前用于评价肝细胞癌免疫治疗的影像学技术主要有CT、MRI、超声和核医学,它们均可以很好地用于评估免疫治疗的有效性,对患者治疗方案的筛选和生存预后的判断有重要价值,但其采用的评价指标大多基于解剖学评价标准,在评价肝细胞癌患者免疫治疗效果方面有一定的局限性。结论免疫治疗作为一种新兴的生物治疗手段已逐步成为未来肝细胞癌诊断与治疗的研究热点,现有影像学技术及评价标准均有一定的局限性,以期有更多功能影像学指标得到完善和发展,为肝细胞癌患者药物治疗评价和临床决策提供有力证据。

Objective To analyze and summarize advantages, disadvantages, and limitations of present imaging techniques in assessing efficacy of immunotherapy for patient with hepatocellular carcinoma in order to provide strong evidence for drug therapy evaluation and clinical decision-making for it. Method The relevant literatures about imaging evaluation of immunotherapy for hepatocellular carcinoma were collected to make a review, then analyze and summarize the value of different imaging techniques. Results The immunotherapy, characterized by the noninvasive, high specificity and good curative effect, had been playing an important role in the treatment of hepatocellular carcinoma in recent years. The imaging techniques currently used to assess the immunotherapy results of hepatocellular carinoma mainly included the CT, MRI, ultrasound, and nuclear medicine, which could be used to better evaluate the effectiveness of immunotherapy. It was very important for screening of the patients＇ treatment options and judging of the survival and prognosis. The most of the evaluation indicators were based on the anatomic evaluation criteria and it had some certain limitations in evaluating the immunotherapy efficacy of patient with hepatocellular carcinoma. Conclusions As an emerging biological therapy, immunotherapy has gradually become a hotspot in diagnosis and treatment of hepatocellular carcinoma in future. Present imaging techniques and evaluation criteria have certain limitations. More multifunctional imaging indicators need to be improved and developed so as to provide strong evidence for drug therapy evaluation and clinical decision of patient with hepatocellular carcinoma.