Immune modulation and focused ultrasound imaging for patients with hepatocellular carcinoma

Abstract

Objective To evaluate immune modulation and the utility of high intensity focused ultrasound (HIFU) imaging for patients with hepatocellular carcinoma.Methods Sixty-three patients with hepatocellular carcinoma were treated using HIFU.Another 39 healthy volunteers served as a control group.A variety of immunological indexes were recorded before and after the treatment and 3 months later.The patients demonstrating good curative effect formed an effective group and those with poor curative effect were the ineffective group.The immunological and clinical indexes of the effective and ineffective groups were compared.The efficacy of the treatment for patients with giant blocks was compared with that for patients with nodular lesions.Contrast-enhanced ultrasono grams (CEUSs) and CT scans of the patients before and after HIFU were recorded.Results All of the immunological indexes [HSP,IFN-γ/IL-10 and TGF-β] were significantly better 1 week and 3 months after treatment than before treatment.Though all of course remained worse than those of the healthy controls throughout.The average indices in the effective group were also of course significantly better than those of the ineffective group,since that is how the groups were defined.Three months after the treatment had ended,self-reported pain,quality of life [Karnosky performance status],total bilirubin and tumor markers were all significantly better than before treatment.And there too the indexes of the effective group were still significantly better than those of the ineffective group.Efficacy was not significantly better among patients with giant blocks (87.5％) than among patients with nodular lesions (66.67％).The CEUS and CT images showed that after HIFU,blood supply to the neoplastic lesions had disappeared,and tumor volume had decreased.Conclusions HIFU is an effective treatment for hepatocellular carcinoma.It can improve patients' anti-tumor response.CEUS can be used to assess quickly the curative effect of HIFU. Key words: Hepatocellular carcinoma; Ultrasound; Ultrasonography; Tumors