Irreversible Electroporation versus Radiofrequency Ablation: Comparison of Systemic Immune Responses in Patients with Hepatocellular Carcinoma

J Vasc Interv Radiol. 2019 Jun;30(6):845-853.e6. doi: 10.1016/j.jvir.2019.03.002.

Abstract

Purpose: Irreversible electroporation (IRE) differs from thermal radiofrequency (RF) ablation, especially in terms of the reparative process in the ablation zone induced. To elucidate this, the systemic immune responses after 2 mechanistically different types of ablation (IRE and RF ablation) were evaluated in patients with hepatocellular carcinoma (HCC).

Materials and methods: Twenty-one patients with HCC who underwent either RF ablation (n = 11) or IRE (n = 10) were studied. Peripheral blood samples were collected from all patients at 4 timepoints: before ablation, within 1 hour after ablation, 1 day after ablation, and 4 days after ablation. The phenotypes and functions of immune cells in peripheral blood and serum levels of cytokines and chemokines were monitored and analyzed using the mixed-effects model. Follow-up radiological images were also obtained to assess temporal changes in the ablation zone.

Results: The most significant difference was seen in the levels of macrophage migration inhibitory factor (MIF) in the IRE group compared to the RF ablation group (P = .0011): the serum levels of MIF in the IRE group significantly increased immediately after IRE and then rapidly decreased to the pre-ablation range 1 day after IRE, but, in contrast, no consistent trend was observed in the RF ablation group. The axial diameter (P = .0009) and area (P = .0192) of the ablation zone of IRE were significantly smaller than those of RF ablation 1 year after ablation.

Conclusions: IRE was found to be associated with a significant early increase in MIF levels, which may facilitate the early reparative process and result in significant shrinkage of the ablation zone.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Ablation Techniques* / adverse effects
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / immunology
  • Carcinoma, Hepatocellular / surgery*
  • Electroporation*
  • Female
  • Humans
  • Intramolecular Oxidoreductases / blood*
  • Liver Neoplasms / blood
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / immunology
  • Liver Neoplasms / surgery*
  • Macrophage Migration-Inhibitory Factors / blood*
  • Male
  • Prospective Studies
  • Radiofrequency Ablation* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Tumor Burden

Substances

  • Macrophage Migration-Inhibitory Factors
  • Intramolecular Oxidoreductases
  • MIF protein, human