Objective:To analyze the efficacy and safety of splenic artery occlusion combined with microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC) complicated with liver cirrhosis and hypersplenism.Methods:Clinical data of 24 patients with HCC complicated with cirrhosis and secondary hypersplenism admitted to Airport Hospital of Tianjin Cancer Hospital from August 2023 to May 2024 were retrospectively analyzed, including 13 males and 11 females, aged (57.4±7.8) years. All patients were treated with splenic artery occlusion combined with MWA of spleen. Spleen volume measured by MRI before and after MWA, blood routine changes and postoperative complications (fever, bleeding, pain, renal failure and thrombosis) were analyzed.Results:The splenic volume of 24 patients measured by MRI before MWA was 692.4 (504.7, 1023.7) cm 3, and decreased to 225.0 (186.4, 285.6) cm 3 after treatment for 60 days ( Z=-3.23, P=0.001). The red blood cell counts were comparable before and after microwave ablation. The white blood cell count before MWA was 4.3 (3.2, 5.3)×10 9/L, which increased to 11.0 (8.6, 15.8)×10 9/L three days after treatment, and to 5.0 (3.3, 6.1)×10 9/L 90 days after treatment ( Z=-4.70, -0.34, P<0.001, P=0.732). The platelet count of the patients was 47.0 (39.0, 67.0)×10 9/L before MWA, which increased to 155.0 (120.3, 214.3)×10 9/L seven days after Treatment, and to 77.0 (63.0, 125.0)×10 9/L 90 days after treatment ( Z=-5.29, -2.51, P<0.001, P=0.012). None of the patients had obvious bleeding and no death occured. One patient (4.2%) developed renal failure, one patient (4.2%) had splenic venous thrombosis, 4 patients (16.7%) had pain of different degrees, and 5 patients (20.8%) had low fever. Conclusion:Splenic artery occlusion combined with MWA in the treatment of HCC complicated with liver cirrhosis and hypersplenism can significantly reduce spleen volume and increase platelet level with acceptable complications.

Objective:To analyze the efficacy and safety of splenic artery occlusion combined with microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC) complicated with liver cirrhosis and hypersplenism.Methods:Clinical data of 24 patients with HCC complicated with cirrhosis and secondary hypersplenism admitted to Airport Hospital of Tianjin Cancer Hospital from August 2023 to May 2024 were retrospectively analyzed, including 13 males and 11 females, aged (57.4±7.8) years. All patients were treated with splenic artery occlusion combined with MWA of spleen. Spleen volume measured by MRI before and after MWA, blood routine changes and postoperative complications (fever, bleeding, pain, renal failure and thrombosis) were analyzed.Results:The splenic volume of 24 patients measured by MRI before MWA was 692.4 (504.7, 1023.7) cm 3, and decreased to 225.0 (186.4, 285.6) cm 3 after treatment for 60 days ( Z=-3.23, P=0.001). The red blood cell counts were comparable before and after microwave ablation. The white blood cell count before MWA was 4.3 (3.2, 5.3)×10 9/L, which increased to 11.0 (8.6, 15.8)×10 9/L three days after treatment, and to 5.0 (3.3, 6.1)×10 9/L 90 days after treatment ( Z=-4.70, -0.34, P<0.001, P=0.732). The platelet count of the patients was 47.0 (39.0, 67.0)×10 9/L before MWA, which increased to 155.0 (120.3, 214.3)×10 9/L seven days after Treatment, and to 77.0 (63.0, 125.0)×10 9/L 90 days after treatment ( Z=-5.29, -2.51, P<0.001, P=0.012). None of the patients had obvious bleeding and no death occured. One patient (4.2%) developed renal failure, one patient (4.2%) had splenic venous thrombosis, 4 patients (16.7%) had pain of different degrees, and 5 patients (20.8%) had low fever. Conclusion:Splenic artery occlusion combined with MWA in the treatment of HCC complicated with liver cirrhosis and hypersplenism can significantly reduce spleen volume and increase platelet level with acceptable complications.

With the continuous development of relevant materials,balloon-occluded transcatheter arterial chemoembolization(TACE)has been gradually applied in clinical practice and has become a clinical hot spot of attention in recent years.The results of preliminary studies indicate that balloon-occluded TACE technology can improve the local control rate and reduce the recurrence rate of lesion in some patients with hepatocellular carcinoma(HCC),and this therapeutic technology can be employed in patients who develop recurrence after receiving conventional TACE and in patients who are scheduled to receive preoperative bridging treatment,besides,it can also be adopted together with selective internal irradiation therapy(SIRT)and ablation therapy.However,how to determine the best suitable patients for the technique,whether this technology will increase liver function damage,whether there are special complications,etc.,are all the issues that need to be paid attention to in clinical application.The technical conditions of its clinical application,prognostic factors and how to combine it with other interventional techniques need to be further discussed.

Objective:To assess the efficacy and safety of computed tomography (CT)-guided percutaneous cryoablation in treating malignant liver tumors located explicitly at high-risk sites.Methods:Data were collected retrospectively from patients with malignant liver tumors undergoing percutaneous cryoablation at Tianjin Medical University Cancer Hospital between January 2018 and December 2021. In all, 46 patients with malignant liver tumors at non-high-risk sites were matched 1∶1 according to the maximum tumor diameter. Technical success rate, complete ablation rate, and complications at 12 and 24 months post-surgery were evaluated. A statistical analysis of the ablation effect difference between the high-risk site and non-high-risk site groups was conducted. Univariate and multivariate logistic regression analyses were performed to identify risk factors.Results:Both groups demonstrated a 100% intraoperative technical success rate, and no major complications related to cryoablation were observed. The complete ablation rate was 82.6% (38/46) and 71.7% (33/46) in the high-risk group and 84.8% (39/46) and 73.9% (34/46) in the non-high-risk group at 12 and 24 months, respectively. There was no significant difference in complete ablation rates between the two groups ( P>0.05). Multivariate analysis identified the distance between the tumor edge and high-risk site ≤5 mm and preoperative trans-arterial chemoembolization (TACE) treatment as independent risk factors for cryoablation effect. Conclusion:CT-guided percutaneous cryoablation is a safe and effective approach for patients with malignant liver tumor at high-risk sites. Our results emphasize the importance of proper preoperative planning and intraoperative manipulation.

Objective:To explore the factors associated with severe bleeding after percutaneous nephrolithotomy (PCNL) in male patients and evaluate the efficacy of interventional embolization.Methods:A retrospective case series study was conducted at Nankai Hospital of Tianjin, China, from January 2018 to October 2021. The clinical data of 230 male patients with upper urinary tract stones were analyzed. The observation indicators included age, hypertension, diabetes, renal function abnormalities, history of preoperative anticoagulant use, stone size, stone type, number of puncture channels, operation time and degree of hydronephrosis. To describe the clinical characteristics of bleeding after percutaneous nephrolithotomy in men, and analyze the factors associated with severe bleeding after PCNL. Single factor analysis was performed using the Chi-square ( χ2) test, and multivariate analysis was performed using logistic regression analysis. Results:Univariate analysis showed that diabetes mellitus ( χ2=4.90, P=0.027), abnormal renal function ( χ2=18.32, P<0.001), history of preoperative oral anticoagulants ( χ2=5.10, P=0.024), abnormal bleeding and coagulation function ( χ2=8.22, P=0.004) and the number of puncture channels ( χ2=22.08, P<0.001) were the related factors affecting bleeding after PCNL. Multivariate logistic regression analysis showed that diabetes mellitus ( P=0.032), abnormal renal function ( P<0.001), and the number of puncture channels ( P<0.001) were the independent risk factors of bleeding after PCNL. Of the 28 patients with bleeding after PCNL, 25 were treated with interventional embolization, with a technical success rate of 100.0% and a clinical success rate of 89.3%. Conclusions:For patients with renal calculi and comorbid diabetes, renal function abnormalities, and multiple punctures, relevant preventive measures should be actively administered before PCNL to reduce the risk of postoperative bleeding. For patients with severe bleeding of the kidney after PCNL, TAE is a safe and effective minimally invasive treatment method.

Objective To evaluate the efficacy and safety of CT-guided percutaneous argon-helium cryoablation in treating hepatic metastases from nasopharyngeal carcinoma. Methods The clinical data of 16 patients with hepatic metastases from nasopharyngeal carcinoma, who had received percutaneous argonhelium cryoablation therapy, were retrospectively analyzed. The quality of life before and after therapy, and the postoperative complications were recorded. After argon-helium cryoablation therapy, the progression-free survival (PFS), the overall survival (OS), and the one-month, 3-month, 6-month, 12-month postoperative tumor local control rates were calculated. Results In all 16 patients, no severe complications occurred and the quality of life was significantly improved after argon-helium cryoablation therapy. The one-month, 3-month, 6-month, 12-month postoperative tumor local control rates were 100％, 87.5％, 80.0％ and 58.3％respectively. The median PFS was 11 months (95％CI: 8.4-13.6 months), and the median survival time was19 months (95％CI: 9.2-28.8 months) . After argon-helium cryoablation therapy, the half-year, one-year and2-year survival rates were 93.8％, 75％ and 43.8％ respectively. Conclusion For the treatment of hepatic metastases from nasopharyngeal carcinoma, CT-guided percutaneous argon-helium cryoablation is minimally-invasive, safe and effective with reliable curative effect.

Objective: To evaluate the effect of immune response of cryoablation combined with anti-CTLA-4 mAb against murine tumor draining lymph nodes (TDLNs) of prostate cancer (PCa). Methods: PCa-bearing murine models were established and mice were divided randomly into 4 groups-control (A), cryoablation treatment (B), cryoablation combined with anti-CTLA-4 mAb treatment (C), and anti-CTLA-4 mAb treatment (D). TDLN specimens were obtained from 5 mice of each group at 4 time points before treatment, and 7, 14, and 21 days after treatment. Tumor size was measured at each time point. Flow cytometry was utilized to detect changes inTreg and CTL proportions in TDLNs. LDH was utilized to detect killing activity for tumor cells of CTL. Overall survival (OS) of each group was recorded. Results: Fourteen days after treatment, compared with that of group A, Treg proportion in group B (9.78%±1.88% vs. 6.02%±0.44%) and C (9.78%±1.88% vs. 6.03%±0.45%) was decreased (both P<0.05); compared with that of group A, CTL proportion of group B (27.34%±2.13% vs . 34.23%±1.15%), C (27.34%±2.13% vs. 52.21%±2.53%), and D (27.34±2.13% vs. 33.99±1.21) was increased (P<0.05, P<0.001, P<0.05); compared with those of group A, CTL killing activities of group B (13.32%±3.39% vs . 26.36%±2.95%), C (13.32%±3.39% vs . 45.25%±3.27%), and D (13.32%±3.39% vs. 25.31%±3.24%) were improved (P<0.05, P<0.001, P<0.05). Survival analysis showed that the OS of PCa-bearing mice were prolonged (P<0.05, P<0.001) in group B (25.60 d±1.52 d vs. 34.20d±6.98 d) and C (25.60 d±1.52 d vs. 43.60 d±2.88 d) compared with that of group A; OS was prolonged (P<0.05) in group C compared with that of group B (34.20d±6.98 d vs. 43.60d±2.88 d). Conclusions: Cryoablation combined with anti-CTLA-4 mAb can reduce the proportions of Tregs in the TDLNs, increase the proportions of CTL as well as killing activities, and significantly prolong OS of mice. However, the specific mechanism needs further study.

Objective To discuss the clinical significance of peripheral neutrophil-to-lymphocyte ratio (NLR) changes in patients with castration-resistant prostate cancer (CRPC) after receiving argon-helium cryoablation.Methods A total of 33 CRPC patients,who were treated with argon-helium cryoablation at Tianjin Medical University Cancer Hospital,were included in this study.The clinical and pathological data were collected and analyzed.The following factors that might affect the postoperative overall survival (OS) of patients were analyzed with univariate and multivariate analysis:age,baseline PSA level,hemoglobin,white blood cell count,platelet count,albumin,alkaline phosphatase,NLR,platelet-to-lymphocyte ratio (PLR),hormone sensitive time,chemotherapy,bone metastasis,Gleason score,ECOG score,PSA effective rate.Results A total of 33 patients were enrolled in this study,the average age was 69 years (50-82 years) and the median survival time was 28 months (6-55 months).Univariate analysis showed that the baseline PSA level,alkaline phosphatase,NLR,hormone sensitive time,chemotherapy,bone metastases,Gleason score and PSA effective rate were significantly correlated with OS of CRPC patients after receiving cryoablation (P＜0.05).Multivariate analysis showed that the baseline PSA level (P=0.003),NLR (P=0.009),Gleason score (P＜0.001) were independent predictive factors for OS of CRPC patients after cryoablation therapy.Conclusion NLR can be used as a prognostic predictor for CRPC patients undergoing argon-helium cryoablation,and the increased NLR indicates a poor prognosis.(J Intervent Radiol,2017,26:237-242)

Recent clinical research shows that the local treatment of primary tumor can improve cancer-specific-survival and overall-survival for metastatic prostate cancer patients.Differ with lymph node metastasis,there is not enough high-level randomized controlled trial data to decide whether the prostate cancer patients with bone metastasis will be benefited from local treatment,meanwhile,it also needs to figure out the factors influencing prognosis of patients.How to efficiently combine multi local treatment with system treatment is a current research hot spot as well.

Objective To investigate the effect of incomplete cryoablation on the biological behavior of prostatic cancer RM-1 cells and its mechanism.Methods RM-1 cells of prostatic cancer were placed in -20℃ icebox to be frozen for 5 min.After the recovery of the cell state,the RM-1 cells were frozen again for 10 min and 15 min successively.After culture for one day,the cellular morphology was microscopically examined.A total of 20 C57/BL mice were used to establish the tumor-bearing models,which were randomly and equally divided into the control group and the incomplete cryoablation group with 10 mice in each group.At scheduled time points the tumor lesion size was measured for all mice.The mice were sacrificed at 14 days,the lung tissues were collected and were stained with lE;the numbers of metastatic lesions in the lung were calculated.Transwell assay was used to test the cell migration and invasion,immuno-blotting method was adopted to determine the epithelial-mesenchymal transition-related (EMT-related) protein expression level,and the enzyme-linked immunosorbent assay (ELISA) was employed to check the secretion volume of transforming growth factor-beta (TGF-β).Results After incomplete cryoablation,RM-1 cells became disorderly arranged,their morphology was changed,and antenna structure might be formed.At 3 and 7 days after cryoablation,the tumor size in the incomplete cryoablation group was slightly smaller than that in the control group,but only the difference at 7 days after cryoablation was statistically significant between the two groups (P=0.019).At 10 and 14 days after cryoablation,the tumor volume of the two groups was almost equal.The pulmonary metastatic lesions in the incomplete cryoablation group were obviously much more than those in the control group (P＜0.001).Transwell assay indicated that the cell migration and invasion ability in the incomplete cryoablation group was stronger than that in the control group (P＜0.05).Immuno-blotting test revealed that,when compared with the control group,in the incomplete cryoablation group the expressions of N-cadherin,MMP-9 and Vimentin were up-regulated,while the expression of E-cadherin was downregulated.ELISA test showed that increased secretion of TGF-β was observed in the incomplete cryoablation group.Conclusion Incomplete cryoablation can enhance the migration and invasion ability of RM-1 cells,increase the number of pulmonary metastatic lesions in tumor-bearing mice,and affect the EMT-related protein expression level.