局部消融术联合免疫检查点抑制剂治疗肝癌的研究进展

Advances in the treatment of local ablation combined with immune checkpoint inhibitors for hepatocellular carcinoma

原发性肝细胞癌为常见恶性肿瘤之一。手术切除及肝移植术是根治性治疗手段,但多数肝癌患者确诊时已失去外科手术机会,不能外科手术的患者常采用局部消融治疗、肝动脉化疗栓塞术等微创治疗。近年来,肝癌的免疫治疗逐渐获得了国内外学者的关注。免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)能减少肝癌微环境的免疫抑制,激活机体抗肿瘤免疫反应,控制并杀伤肿瘤细胞。局部消融术通过破坏肿瘤细胞来诱导机体免疫调节,以增强抗肿瘤免疫反应。因此,探究局部消融与ICIs协同增强抗肿瘤免疫反应的作用具有重要的临床意义。文章对局部消融联合ICIs治疗肝癌的研究现状及进展进行综述,并作出展望。

Hepatocellular carcinoma is one of the most common malignant tumors.Surgical resection and liver transplantation are effective ways to cure liver cancer,but most patients have missed the chance of surgical treatment when diagnosed.Local ablation,hepatic artery chemoembolization and other minimally invasive methods are often used in patients who can’t undergo surgery.In recent years,immunotherapy of HCC has gradually gained the attention of researchers at home and abroad.Immune checkpoint inhibitors(ICIs)can reduce the immunosuppression of HCC microenvironment,activate anti-tumor immune response,control and kill tumor cells.Local ablation induces immune regulation to enhance anti-tumor immune response by destroying tumor cells.Therefore,it is of great clinical significance to explore the synergistic effect of ablation and ICIs on enhancing anti-tumor immune response.This article reviews the research status and progress of ablation combined with ICIs in the treatment of hepatocellular carcinoma and prospects the future.