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Adverse Pregnancy Outcomes Following Cryotherapy, thermal ablation and Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia Treatment: A Pilot Study among Zambian Women

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 7-17页

作者： Victoria Mwiinga-Kalusopa Johanna E. Maree Concepta Kwaleyela Patricia Katowa-Mukwato Department of Basic and Clinical Nursing University of Zambia Lusaka Zambia Department of Nursing Education University of Witwatersrand Johannesburg Gauteng South Africa School of Health Sciences Mulungushi University Kabwe Central Province Zambia

Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who according to literature may be at risk of adverse pregnancy outcomes. This pilot study is part of a study investigating adverse pregnancy outcomes among women who received Cryotherapy, thermal ablation and Loop Electrosurgical Excision Procedure compared to the untreated women in Zambia. Materials and Methods: This descriptive study analyzed records of 886 (n = 443 treated and n = 443 untreated) women aged 15 - 49 years. The women were either screened with Visual Inspection with Acetic Acid or treated for Cervical Intraepithelial neoplasia at the Adult Infectious Disease Centre between January 2010 and December 2020. Women meeting the criteria were identified using the Visual Inspection with Acetic Acid screening records and telephone interviews to obtain the adverse pregnancy outcome experienced. Data were analysed using STATA version 16 to determine the prevalence and obtain frequency distribution of outcomes of interest. Univariate and multivariable binary logistic regression estimated odds of adverse pregnancy outcomes across the three treatments. Results: The respondents were aged 15 to 49 years. Adverse pregnancy outcomes were observed to be more prevalent in the treatment group (18.5%) compared to the untreated group (5.4%). Normal pregnancy outcomes were lower in the treated (46.3%;n = 443) than the untreated (53.7%;n = 443). The treated group accounted for the majority of abortions (85.2%), prolonged labour (85.7%) and low birth weight (80%), whereas, the untreated accounted for the majority of still births (72.7%). Women treated with cryotherapy (aOR = 2.43, 95% CI = 1.32 - 4.49, p = 0.004), thermal ablation (aOR = 6.37, 95% CI = 0.99 - 41.2, p = 0.052) and Loop Electrosurgical Excision Procedure (aOR = 9.67, 95% CI = 2.17 - 43.1, p = 0.003)

关键词： Adverse Pregnancy Outcomes Cervical Intraepithelial Neoplasia Cryothera-py thermal ablation Loop Electrosurgical Excision Procedure Pilot Repro-ductive Age

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Mechanisms and therapeutic strategies to combat the recurrence and progression of hepatocellular carcinoma after thermal ablation

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Journal of Interventional Medicine 2023年第4期6卷 159-168页

作者： Feilong Ye Lulu Xie Licong Liang Zhimei Zhou Siqin He Rui Li Liteng Lin Kangshun Zhu Laboratory of Interventional Radiology Department of Minimally Invasive Interventional Radiology and Department of RadiologyThe Second Affiliated Hospital of Guangzhou Medical University250 East Changgang RoadGuangzhouGuangdong Province510260China

thermal ablation(TA),including radiofrequency ablation(RFA)and microwave ablation(MWA),has become the main treatment for early-stage hepatocellular carcinoma(HCC)due to advantages such as safety and minimal ***,HCC is prone to local recurrence,with more aggressive malignancies after TA closely related to TA-induced changes in epithelial-mesenchymal transition(EMT)and remodeling of the tumor microenvironment(TME).According to many studies,various components of the TME undergo complex changes after TA,such as the recruitment of innate and adaptive immune cells,the release of tumor-associated antigens(TAAs)and various cytokines,the formation of a hypoxic microenvironment,and tumor *** in the TME after TA can partly enhance the anti-tumor immune response;however,this response is weak to kill the tumor *** components of the TME can induce an immunosuppressive microenvironment through complex interactions,leading to tumor recurrence and *** the TME is remodeled after TA and the mechanism by which the TME promotes HCC recurrence and progression are ***,in this review,we focused on these issues to highlight potentially effective strategies for reducing and preventing the recurrence and progression of HCC after TA.

关键词： Hepatocellular carcinoma thermal ablation Microenvironment Recurrence and progression Therapeutic strategies

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thermal ablation versus conventional regional hyperthermia has greater anti-tumor activity against melanoma in mice by upregulating CD4~+ cells and enhancing IL-2 secretion

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Progress in Natural Science:Materials International 2009年第12期19卷 1699-1704页

作者： Yingying Zhang~(a,b),Wei Zhang~b,Cuanying Geng~c,Tongjun Lin~d,Xiaowen Wang~b, Lingyun Zhao~b,Jintian Tang~(b,*) a Department of Oncology,Xiangya Hospital,Central South University,Changsha 410008,China b Institute of Medical Physics and Engineering,Department of Engineering Physics,Tsinghua University,Beijing 100084,China c Clinical Medical Research Center,China-Japan Friendship Hospital,Beijing 100029,China d Department of Microbiology & Immunology,Department of Pediatrics,IWK Health Centre,Dalhousie University,5850 University Avenue, Halifax,NS,Canada B3J 3G9 Department of Oncology Xiangya Hospital Central South University Changsha 410008 China Institute of Medical Physics and Engineering Department of Engineering Physics Tsinghua University Beijing 100084 China Clinical Medical Research Center China–Japan Friendship Hospital Beijing 100029 China Department of Microbiology & Immunology Department of Pediatrics IWK Health Centre Dalhousie University 5850 University Avenue Halifax NS Canada B3J 3G9

To determine whether conventional hyperthermia(42-15℃) or ablation therapy(>50℃) achieves better synergistic effects on direct cytotoxicity and anti-tumor immunity,we compared the therapeutic effects of two hyperthermia temperatures,43 and 55℃,in terms of cytotoxicity and upregulation of immune functions in a mouse malignant melanoma ***-bearing mice were treated by directly applying regional hyperthermia to the tumor nodule with a heating light at a temperature of 43℃for 30 min or 55℃for 10 *** tumor growth curve and mice survival rate were *** investigate the hyperthermia-induced immunological response,peripheral blood CD4~+ and CD8~+ T cells and the serum IL-2 level were *** results indicated that application of regional hyperthermia at the ablation temperature(such as 55℃) achieved better synergistic anti-tumor effects than did conventional hyperthermia(43℃).Significant increases in the number of peripheral blood CD4~+ T cells and the serum IL-2 level likely contributed to the underlying mechanism.

关键词： Hyperthermia thermal ablation Melanoma Immunity response

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thermal ablation and immunotherapy for hepatocellular carcinoma:Recent advances and future directions

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World Journal of Gastrointestinal Oncology 2021年第10期13卷 1397-1411页

作者： Xiao-Wan Bo Li-Ping Sun Song-Yuan Yu Hui-Xiong Xu Center of Minimally Invasive Treatment for Tumor Department of Medical UltrasoundShanghai Tenth People’s HospitalUltrasound Research and Education InstituteClinical Research Center for Interventional MedicineSchool of MedicineTongji UniversityShanghai 200072China Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment National Clinical Research Center for Interventional MedicineShanghai 200072China

Hepatocellular carcinoma(HCC)is one of most common cancers that cause death in the *** ablation(TA)is an important alternative treatment method for HCC patients who are not appropriate for surgery or liver *** for small and early HCCs,TA can be considered as the first-line curative ***,local and distant recurrence rates are still high even though the TA equipment and technology develop *** is a novel systemic treatment method to enhance the anti-tumor immune response of HCC patients,which has the potential to reduce the tumor recurrence and *** combination of local TA and systemic immunotherapy for HCCs may be an ideal treatment for enhancing the efficacy of TA and controlling the *** we summarize the latest progress in TA,immunotherapy,and their combination for the treatment of patients with HCC and discuss the limitations and future research directions of the combined therapy.

关键词： Hepatocellular carcinoma thermal ablation Radiofrequency ablation Immunotherapy Recurrence Anti-tumor immune response

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thermal ablation for papillary thyroid microcarcinoma: Some clarity amid controversies

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Journal of Interventional Medicine 2022年第4期5卷 171-172页

作者： Wenwen Yue Shurong Wang Huixiong Xu Department of Medical Ultrasound Shanghai Tenth People's HospitalUltrasound Research and Education InstituteSchool of MedicineTongji UniversityShanghai Engineering Research Center of Ultrasound Diagnosis and TreatmentShanghai200072PR China Department of Ultrasound Yantai Hospital of Shandong Wendeng Orthopaedics&TraumatologyYantai264499PR China Department of Ultrasound Zhongshan HospitalFudan UniversityShanghai200032PR China

The increasing incidence of papillary thyroid microcarcinoma(PTMC)has become a global *** of its indolent nature,active surveillance(AS)has been proposed as a treatment option in selected PTMC patients to prevent surgery-related ***,only a few patients with PTMC receive the AS approach because of the serious psychological burden following the“cancer”diagnosis and the uncertainty of the timing for metastatic ***(US)-guided thermal ablation can bridge the gap in the treatment options of PTMC patients who wish for a minimally invasive management ***,it has acquired only marginal attention from the thyroid guideline societies because of concerns regarding incomplete *** recently published guidelines from the European Thyroid Association-Cardiovascular and Interventional Radiological Society of Europe and the American Head Neck Society Endocrine Section-initiated global consensus provide the most definitive evidence and essential foundational experience to address the long-term controversy over USguided thermal ablation for low-risk PTMC patient management and facilitate the responsible global dissemination of minimally invasive strategies.

关键词： Papillary thyroid microcarcinoma thermal ablation Thyroid Ultrasound

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Potential application of ultrasound-guided thermal ablation in rare liver tumors

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 531-537页

作者： Li-Li Wu Jia-Xin Chen Kai Li Zhong-Zhen Su Ying-Lin Long Li-Ping Luo Er-Jiao Xu Rong-Qin Zheng Department of Medical Ultrasonics Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Key Laboratory of Liver Disease ResearchGuangzhou 510630China Department of Medical Ultrasonics Fifth Affiliated Hospital of Sun Yat-sen UniversityZhuhai 519000China

Background: With the advances of imaging techniques, the detection rate of rare liver tumor is increased. However, the therapeutic strategies of the rare liver tumors remain limited. Methods: We analyzed twelve pathologically confirmed rare liver tumors in 8 patients. All of the patients underwent ultrasound(US) guided biopsy and subsequent thermal ablation. The tumors were ablated according to the preoperative plans and monitored by real-time US. CT/MRI fused with contrast enhanced US(CEUS) or three-dimensional(3 D) US-CEUS images were used to guide and assess the ablation zone more accurately during thermal ablation. The rate of technical efficacy was assessed based on the contrast-enhance CT/MRI(CECT/MRI) results one month after ablation. Local tumor progression(LTP), recurrence and complications were followed up and recorded. Results: Among these twelve nodules, nine were subject to US-guided thermal ablation, whereas the other three inconspicuous nodules were subject to CEUS-guided thermal ablation. Intra-procedure CT/MRI-CEUS or 3 D US-CEUS fusion imaging assessments demonstrated that the ablation zone sufficiently covered the original tumor, and no immediate supplementary ablation was required. Additionally, no major complications were observed during the follow-up period. The postoperative CECT/MRI confirmed that the technique success rate was 100%. Within the surveillance period of 13 months, no LTP or recurrence was noted. Conclusions: US-guided thermal ablation was feasible and safe for rare liver tumors. The use of fusion imaging technique might make US-guided thermal ablation as effective as surgical resection, and this technique might serve as a potential therapeutic modality for rare liver tumors in the future.

关键词： Contrast-enhanced ultrasound thermal ablation Rare liver tumor Fusion imaging

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Residual tumor and central lymph node metastasis after thermal ablation of papillary thyroid carcinoma: A case report and review of literature

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World Journal of Clinical Cases 2021年第1期9卷 252-261页

作者： Yu Hua Jia-Wen Yang Liu He Hua Xu Hai-Zhong Huo Chen-Fang Zhu Department of General Surgery Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineDiscipline Construction Research Center of China Hospital Development InstituteShanghai Jiao Tong UniversityShanghai 200011China

BACKGROUND Debate exists regarding the use of thermal ablation(TA)to treat papillary thyroid carcinoma(PTC).Some studies have recommended TA as a new,efcient and safe technology for *** this article,we report one case of a residual tumor and central lymph node metastasis(CLNM)after TA for *** SUMMARY A 63-year-old female underwent bilateral ultrasound(US)-guided radiofrequency ablation for *** months later,she was diagnosed as thyroid cancer with suspected CLNM by US and contrast-enhanced computed *** subsequent fine-needle aspiration(FNA)biopsies were *** to her strong personal preference,she underwent total thyroidectomy and central lymph node *** tissue adhesion and a difficult dissection were noted during the *** pathology of the frozen sections during the operation was still *** final pathology results of paraffin-embedded sections revealed residual tumor cells at the edge of the PTC and *** TA may lead to a residual tumor in patients with ***-up using US and FNA biopsy may not be adequate to evaluate the residual *** should be carefully considered in PTC treatment.

关键词： Papillary thyroid carcinoma thermal ablation Residual tumor Central lymph node metastasis Follow-up Case report

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Intrahepatic Cholangiocarcinoma and thermal ablation:Long-term Results of An Italian Retrospective Multicenter Study

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Journal of Clinical and Translational Hepatology 2019年第4期7卷 287-292页

作者： Antonio Giorgio Pietro Gatti Luca Montesarchio Bruno Santoro Andrea Dell’Olio Nicola Crucinio Carmine Coppola Ferdinando Scarano Fabio De Biase Emanuela Cirac Stefano Semeraro Valentina Giorgio Liver Unit and Interventional Ultrasound Unit Athena Clinical InstitutePiedimonte Matese(CE)Italy Internal Medicine Unit Brindisi General HospitalBrindisiItaly General Surgery Unit Polla General HospitalPolla(SA)Italy Department of Radiology Bisceglie Hospital-ASL BATBisceglieItaly Gastroenterology Unit Foggia General HospitalFoggiaItaly Department of Internal Medicine Hepatology Interventional UnitGragnano HospitalGragnano(NA)Italy Internal Medicine Unit Ostuni HospitalOstuni(BR)Italy Fondazione Policlinico A.Gemelli IRCCS Department of Woman and Child Health and Public HealthLargo A GemelliRomaItaly

Background and Aims: Despite resection being considered the treatment of choice for intrahepatic cholangiocarcinoma(ICC),percutaneous thermal ablation can be an alter-native treatment for patients unfit for *** aim was to compare long-term results of percutaneous sonographi-cally-guided radiofrequency ablation(RFA)with high-powered microwave ablation(MWSA)in treatment of ***: Results of 71 ICC patients with 98 nodules treated with RFA(36 patients)or MWSA(35 patients)between January 2008 and June 2018 in 5 Interventional Ultrasound centers of Southern Italy were retrospectively ***-mulative overall survival curves were calculated with the Ka-plan-Meyer method and differences with the log-rank *** possible factors affecting survival were ***: Overall survival of the entire series was 88%,65%,45%and 34%at 12,36,60 and 80 months,*** treated with MWSA survived longer than pa-tients treated with RFA(p 4 cm,no significant difference was ***-free sur-vival and progression-free survival were better in the MWSA group compared to the RFA group(p < 0.005).Diameter of nodules and MWSA were independent factors predicting a better *** major complications were ***: MWSA is superior to RFA in treating ICC unfit for surgery,achieving better long-term survival in small(≤3 cm)ICC nodules as well as nodules up to 4 cm of neo-plastic tumors and should replace RFA.

关键词： Intrahepatic cholangiocarcinoma thermal ablation Microwaves Radiofrequency Percutaneous treatment

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Nanodrug enhances post-ablation immunotherapy of hepatocellular carcinoma via promoting dendritic cell maturation and antigen presentation

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Bioactive Materials 2023年第3期21卷 57-68页

作者： Zecong Xiao Tan Li Xinyao Zheng Liteng Lin Xiaobin Wang Bo Li Jingjun Huang Yong Wang Xintao Shuai Kangshun Zhu Department of Minimally Invasive Interventional Radiology And Laboratory of Interventional RadiologyThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou510260China Nanomedicine Research Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou510630China College of Chemistry and Materials Science Jinan UniversityGuangzhou510632China Department of Dermatology The Nanfang Hospital of Southern Medical UniversityGuangzhouGuangdong510515China

thermal ablation(TA)as an effective method treating hepatocellular carcinoma(HCC)in clinics is facing great challenges of high recurrence and *** immune-checkpoint blockade(ICB)-based immuno-therapy has shown potential to inhibit recurrence and metastasis,the combination strategy of ICB and thermal ablation has shown little progress in HCC *** tremendous hurdle for combining ICB with thermal ablation lies with the insufficient antigen internalization and immaturity of tumor-infiltrating dendritic cells(TIDCs)which leads to an inferior immune response to distant tumor growth and ***,an antigen-capturing nanoplatform,whose surface was modified with mannose as a targeting ligand,was constructed for co-delivering tumor-associated antigens(TAAs)and m6A demethylases inhibitor(i.e.,fat mass and obesity asso-ciated gene(FTO)inhibitor)into *** vivo results demonstrate that the intratumoral injection of nanodrug followed by HCC thermal ablation promotes dendritic cells(DCs)maturation,improves tumor infiltration of effector T cells and generates immune memory,which synergize with ICB treatment to inhibit the distant tumor growth and lung ***,the antigen-capturing and FTO-inhibiting nanodrug holds potential to boost the ICB-based immunotherapy against HCC after thermal ablation.

关键词： thermal ablation Tumor-infiltrating dendritic cells N6-methyladenosine modification Nanoplatform Tumor immunotherapy

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Predictors of early and late hepatocellular carcinoma recurrence

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World Journal of Gastroenterology 2023年第8期29卷 1243-1260页

作者： Riccardo Nevola Rachele Ruocco Livio Criscuolo Angela Villani Maria Alfano Domenico Beccia Simona Imbriani Ernesto Claar Domenico Cozzolino Ferdinando Carlo Sasso Aldo Marrone Luigi Elio Adinolfi Luca Rinaldi Department of Advanced Medical and Surgical Sciences University of Campania“Luigi Vanvitelli”Naples 80138Italy Internal Medicine and Hepatology Unit Ospedale Evangelico BetaniaNaples 80147Italy

Hepatocellular carcinoma(HCC)is the most frequent liver neoplasm,and its incidence rates are constantly *** the availability of potentially curative treatments(liver transplantation,surgical resection,thermal ablation),long-term outcomes are affected by a high recurrence rate(up to 70%of cases 5 years after treatment).HCC recurrence within 2 years of treatment is defined as“early”and is generally caused by the occult intrahepatic spread of the primary neoplasm and related to the tumor burden.A recurrence that occurs after 2 years of treatment is defined as“late”and is related to de novo HCC,independent of the primary *** HCC recurrence has a significantly poorer prognosis and outcome than late *** pathogenesis corresponds to different predictors of the risk of early or late *** adequate knowledge of predictive factors and recurrence risk stratification guides the therapeutic strategy and post-treatment *** at high risk of HCC recurrence should be referred to treatments with the lowest recurrence rate and when standardized to combined or adjuvant therapy *** review aimed to expose the recurrence predictors and examine the differences between predictors of early and late recurrence.

关键词： Hepatocellular carcinoma Early recurrence Late recurrence Predictors Liver transplant Liver resection thermal ablation

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