Efficacy and safety of computed tomography-guided microwave ablation with fine needle-assisted puncture positioning technique for hepatocellular carcinoma

BACKGROUND In microwave ablation(MWA), although computed tomography(CT) scanning can overcome gas interference, it cannot achieve real-time localization. Therefore, the puncture technique is more important in CT-guided ablation.AIM To compare the fine needle-assisted puncture(FNP) positioning technique and the conventional puncture(CP) technique for the safety and efficacy of CT-guided MWA in treating hepatocellular carcinoma(HCC).METHODS This retrospective study included 124 patients with 166 tumor nodules from February 2018 and June 2021. Seventy patients received CT-guided MWA under the FNP technique(FNP group), and 54 patients received MWA under the CP technique(CP group). Intergroup comparisons were made regarding local tumor progression(LTP), recurrence-free survival(RFS), overall survival(OS), and complications. The influencing variables of LTP and RFS were analyzed through univariate and multivariate regressions.RESULTS The 1-, 2-, and 3-year cumulative incidences of LTP in the FNP group were significantly lower than those in the CP group(7.4%, 12.7%, 21.3% vs 13.7%, 32.9%, 36.4%;P = 0.038). The 1-, 2-, and 3-year RFS rates in the FNP group were significantly higher than those in the CP group(80.6%, 73.3%, 64.0% vs 83.3%,39.4%, and 32.5%, respectively;P = 0.008). The FNP technique independently predicted LTP and RFS. Minor complications in the FNP group were lower than those in the CP group(P < 0.001). The difference in median OS was insignificant between the FNP and CP groups(P = 0.229).CONCLUSION The FNP technique used in CT-guided MWA may improve outcomes in terms of LTP, RFS, and procedure-related complications for HCC.

Role of mitophagy in head and neck squamous cell carcinoma:Prognosis and immune insights

Objective:To explore the correlation between mitophagy and the tumor microenvironment(TME)in patients with head and neck squamous cell carcinoma(HNSCC),with an aim to enhance therapeutic efficacy for HNSCC.Methods:A machine learning-based multigene prognostic signature was developed based on mitophagy-related differentially expressed genes(MRGs)identified in The Cancer Genome Atlas cohort.This signature was correlated with the TME using gene set enrichment analysis.The association between this prognostic signature and various immunological features of the TME was explored,including status of tumor-infiltrating immune cells,expression of immune checkpoint molecules,and the immunoscore.Immunohistochemistry validated the expression of hub gene CSNK2A2 and assessed its relationship with immunomarker expression.Quantitative PCR validated CSNK2A2 knockdown in HNSCC cell lines.Functional experiments including Transwell assays to determine cell migration and invasion,Cell Counting Kit 8 assay,and 5-ethynyl-2-deoxyuridine assay were performed to confirm the role of CSNK2A2 in HNSCC.Finally,a subcutaneous xenograft model was generated in C3H mice to validate our findings.Results:The MRG-based prognostic signature showed excellent predictive performance.High-risk patients had significantly shorter progression-free and overall survival(P<0.0001)than low-risk patients.CD8+T cell infiltration was lower in high-risk groups,whereas low-risk groups showed higher immunological marker expression.Thus,the low-risk HNSCC subtype may benefit from immune therapy,while high-risk subtypes may benefit from chemotherapy(P<0.001).CSNK2A2 was highly expressed and strongly correlated with CD8 and PD-L1 based on immunohistochemistry of the HNSCC tissue microarray.CSNK2A2 knockdown reduced cell migration,invasion,and proliferation,and arrested cells in G1 phase.In vivo,it led to slower tumor growth and smaller tumor volumes.Conclusion:We established a potential prognostic signature that could improve HNSCC management in the future.CSNK2A2 may be a new biomarker to predict immunotherapy efficacy in HNSCC.