局部区域治疗对肝细胞癌免疫微环境的双重调控机制及联合治疗策略

王恩毓; 王宏博; 张立欧

doi:10.12449/JCH260529

局部区域治疗对肝细胞癌免疫微环境的双重调控机制及联合治疗策略

DOI: 10.12449/JCH260529

1.
中国医科大学第二临床学院，沈阳 110122
2.
中国医科大学附属盛京医院介入科，沈阳 110004

基金项目:

国家自然科学基金 (82202280)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：王恩毓负责设计论文框架，起草论文；王宏博负责相关文献检索和整理；张立欧负责拟定写作思路，修改文章并最后定稿。

详细信息

通信作者:
张立欧， zhangliou1@163.com （ORCID： 0009-0009-8666-7861）

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出版历程
- 收稿日期: 2025-09-29
- 录用日期: 2025-12-10
- 出版日期: 2026-05-20

The dual regulatory effect of locoregional therapy on the tumor immune microenvironment of hepatocellular carcinoma： Mechanisms and combined treatment strategies

Enyu WANG¹,
Hongbo WANG²,
Liou ZHANG^{2
, ,
,}

1.
The Second Clinical College of China Medical University，Shenyang 110122，China
2.
Department of Interventional Radiology，Shengjing Hospital of China Medical University，Shenyang 110004，China

Research funding:

National Natural Science Foundation of China (82202280)

More Information

Corresponding author: ZHANG Liou， zhangliou1@163.com （ORCID： 0009-0009-8666-7861）

摘要

摘要: 局部区域治疗（LRT），如经导管动脉化疗栓塞术、经导管动脉放射栓塞术及消融等，是肝细胞癌的重要治疗手段。近年来多项研究证实其对肿瘤免疫微环境具有双重调节作用：LRT在诱导免疫原性细胞死亡、激活树突状细胞与T细胞免疫并激发全身抗肿瘤应答的同时，亦可上调腺苷通路、促进髓系细胞触发受体2⁺巨噬细胞聚集并增加免疫抑制因子表达，进而形成免疫抑制性微环境。目前，LRT与免疫检查点抑制剂的联合治疗前景广阔，并推动了对相关免疫抑制通路新靶点（如腺苷、髓系细胞触发受体2⁺、白细胞介素6）的探索。本文旨在总结LRT对免疫微环境的双重调控作用，强调未来需借助多组学技术与临床试验解析其动态变化，以优化联合策略，实现个体化精准治疗并改善患者预后。
- 癌，肝细胞 /
- 肿瘤微环境 /
- 化学栓塞，治疗性 /
- 消融技术
Abstract: Locoregional therapy （LRT）， including transarterial chemoembolization， transarterial radioembolization， and various ablation techniques， is an important treatment method for hepatocellular carcinoma. Many studies in recent years have confirmed that LRT has a dual regulatory effect on tumor immune microenvironment. While LRT induces immunogenic cell death， activates dendritic cell-mediated and T cell-driven immunity， and triggers systemic antitumor responses， it concomitantly upregulates the adenosine signaling pathway， promotes the accumulation of TREM2⁺ macrophages， and enhances the expression of immunosuppressive factors， thereby forming an immunosuppressive microenvironment. At present， the combination of LRT and immune checkpoint inhibitors has shown a promising future and has promoted the exploration of novel targets within treatment-associated immunosuppressive pathways， such as adenosine， TREM2⁺ macrophages， and IL-6. This article summarizes the dual regulatory effect of LRT on immune microenvironment and highlights that multi-omics techniques and clinical trials should be used in the future to decipher its dynamic alterations， in order to optimize combination strategies， realize individualized precise treatment， and improve the prognosis of patients.
- Carcinoma， Hepatocellular /
- Tumor Microenvironment /
- Chemoembolization， Therapeutic /
- Ablation Techniques

HTML全文

注： TACE，经导管动脉化疗栓塞术；TARE，经导管动脉放射栓塞术；PEI，经皮乙醇注射；TREM2，髓系细胞触发受体2；DAMP，损伤相关分子模式；HSP，热休克蛋白；TGF-β，转化生长因子β；PD-L1，程序性细胞死亡配体1；Treg，调节性T细胞；MDSC，髓源性抑制细胞；cGAS-STING，环鸟苷酸-腺苷酸合成酶-干扰素基因刺激蛋白；IFN-Ⅰ，Ⅰ型干扰素；NF-κB，核因子κB；IL-6，白细胞介素6；TNF-α，肿瘤坏死因子α；ROS，活性氧；ATP，三磷酸腺苷；CXCL9，趋化因子配体9。

图 1 TACE、TARE与消融治疗调控HCC免疫微环境的机制

Figure 1. Mechanisms of TACE， TARE， and ablation therapy in modulating the immune microenvironment of HCC

下载: 全尺寸图片幻灯片

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