For a long time, the morbidity and mortality rates of hepatocellular carcinoma (HCC) have remained high. Since the concept of ferroptosis was introduced in 2012, researchers' perspectives have shifted toward finding novel ferroptosis-related treatment strategies, especially for tumors that are resistant to apoptosis. In recent years, there have been an increasing number of studies on ferroptosis, and these studies have found that ferroptosis has great potential and promise for cancer treatment. Ferroptosis is a kind of regulated cell death (RCD); unlike apoptosis, ferroptosis is an iron-dependent type of RCD driven by lipid peroxidation. The whole process of ferroptosis mainly revolves around three pathways (system xc-/ glutathione peroxidase 4 [GPX4]), lipid peroxidation, and iron metabolism), which are also regulated by various metabolic factors. This review will attempt to analyze the relationship between the system xc-/GPX4 pathway, lipid peroxidation, iron metabolism, and ferroptosis from three aspects (triggering, execution, and regulation), and the regulatory factors for ferroptosis will be summarized. In this review, we will also illustrate the relationship between ferroptosis and tumors as well as its application in tumors from the perspective of HCC. Finally, we will summarize the current limitations and needs and provide perspectives related to the focus of development in the future.
Humans ; Ferroptosis ; Carcinoma, Hepatocellular/metabolism* ; Phospholipid Hydroperoxide Glutathione Peroxidase/metabolism* ; Cell Death ; Liver Neoplasms/metabolism* ; Lipid Peroxidation ; Iron/metabolism*

Objective:To investigate the current status of interventional radiology discipline in the provincial-level and national cancer hospitals of China, and to provide supportive data for the future systematic construction of interventional radiology.Methods:A questionnaire was used to survey 32 provincial and national cancer hospitals of China. The survey included data such as discipline settings, medical treatment, medical education, and scientific research. Then descriptive statistical analysis was performed based on the data.Results:All 32 provincial and national cancer hospitals of China had interventional radiology services and were equipped with independent wards; the deployment rates of DSA, ultrasound, CT, and radiofrequency ablation equipments were: 100%(32/32), 81.3%(26/32), 40.6%(13/32), and 75.0%(24/32), respectively. Of all 32 hospitals, 27 (84.4%) had performed more than 1 000 interventional operations per year. The proportion of hospitals that had interventional subspecialties was 21.9% (7/32). As for the interventional radiology doctors in these hospitals, the ratio of doctors with a background of medical imaging specialty was 69.6%(256/368); the proportion of doctors with ages ≤ 45 years old was 72.0%(265/368); and the ratio of doctors with a master degree was 79.9%(294/368). Among the 32 hospitals, 22 (68.8%) had more than 500 000 yuan research funds in intervention radiology discipline, and 71.9%(23/32) had intervention radiology discipline postgraduate tutors.Conclusions:The overall development of interventional radiology discipline in provincial-level and national cancer hospitals is good. The discipline development pattern might set a good example for interventional radiology discipline construction in general hospitals.

Objective:To evaluate the feasibility and safety of a novel transjugular intrahepatic portosystemic shunt (TIPS) puncture set for transjugular intrahepatic portal puncture in swine.Methods:Thirteen domestic swine were randomly divided into experimental group ( n=7) and control group ( n=6) and received transjugular intrahepatic portal puncture with the novel puncture set and the R?sch-Uchida Transjugular Liver Access Set (RUPS-100), respectively. Three swines in each group were randomly selected and sacrificed immediately after the procedure and the rest were sacrificed 1 week later. The intraoperative technical success rate, puncture attempts, procedure time, fluoroscopy time, vital signs and occurrence of complications related to the procedure as well as the changes of liver and kidney function before, immediately after and 1 week after the procedure were compared between two groups. Independent sample t test, paired t test, Mann-Whitney U test, chi-square test or Fisher′s exact test were performed to compare the differences between groups. Results:The technical success rate was 100% for both groups. No significant difference in portal puncture attempts [2.0 (1.0, 5.0) vs. 2.0(1.0, 5.5), P>0.999], procedure time [(47.7±20.6) vs. (52.5±28.0)min, P=0.729] and fluoroscopy time [(725.1±489.2) vs. (763.7±562.4)s, P=0.897] was observed between two groups. In addition, no significant difference of the major liver and kidney function between two groups before, immediately after and 1 week after procedure ( P>0.05 at all time points). No significant difference of the major liver and kidney function change in two groups during perioperative period was identified (all P>0.05). Furthermore, no significant difference of non-target puncture occurrence was observed between two groups ( P>0.999). In the meantime, no significant difference of occurrence of small hematomas around hepatic hilar was discovered among swine sacrificed immediately after procedure between two groups ( P>0.999). No other major complications were identified in either group. Conclusion:The novel TIPS puncture set is feasible and safe to perform transjugular intrahepatic portal puncture in swine.

The vast majority of patients with hepatocellular carcinoma (HCC) in China originate from hepatitis B cirrhosis, while 90% of cirrhotic patients may develop portal hypertension, and the HCC patients with portal hypertension account for 15%-30%. Portal hypertension is a group of clinical syndromes characterized by elevated portal venous pressure and formation of portal-systemic collateral circulation, and it is one of the most important complications of liver cirrhosis. HCC and portal hypertension affect each other, and portal hypertension seriously affects the prognosis of HCC patients. The development of systemic treatment regimens for HCC provides more treatment options for patients with advanced HCC, including molecular-targeted drug therapy, immunotherapy, and chemotherapy. Different systemic therapeutic drugs for HCC have different impacts on portal hypertension, and this article reviews the effect of commonly used systemic therapeutic drugs for HCC on portal hypertension.