Alterations in serum metabolic profiles of early-stage hepatocellular carcinoma patients after radiofrequency ablation therapy

OBJECTIVE

To investigate the alterations in serum metabolic profiles and early-stage hepatocellular carcinoma (HCC) patient characteristics after radiofrequency ablation (RFA) therapy. This evaluation aimed to assess treatment effectiveness and identify potential novel approaches and targets for HCC treatment and prognosis monitoring.

METHODS

Untargeted metabolomics technology was employed to analyze serum metabolic profiles in healthy volunteer controls (NCs) and early stage HCC patients before and after RFA therapy. Additionally, Human Metabolome Database and Kyoto Encyclopedia of Genes and Genomes database were used to identify the differential metabolites (DMs) and metabolic pathways. Cystoscape was utilized to construct DM gene networks. Amino acid analyses were performed to validate our findings.

RESULTS

We identified 11, 14, and six DMs between the NC and HCC groups, HCC patients before and after RFA therapy, and post-RFA HCC and NC groups, respectively. The expression levels of these DMs, particularly those of amino acids and lipids, significantly changed. Compared with the NC group, higher levels of L-tyrosine, aspartate, and 18-oxo-oleate were observed in HCC patients, which were significantly reduced in patients after RFA therapy. Meanwhile, HCC patients after RFA therapy had increased levels of L-arginine, phosphatidic acid (20:3), and lysophosphatidyl choline (LPC) (20:4) compared to those before therapy, while their levels before therapy were lower than those of NC. Moreover, most metabolites in the post-RFA and NC groups showed no significant changes in expression, except for L-tyrosine and LPC (16:0). These metabolites could potentially serve as characteristic factors of early-stage HCC patients after RFA therapy. Joint pathway analysis revealed striking changes, mainly in phenylalanine, tyrosine, and tryptophan biosynthesis; alanine, aspartate, and glutamate metabolism; and arginine and aminoacyl-tRNA biosynthesis. Bioinformatics analysis of publicly available data preliminarily identified 187 DM-related metabolic enzymes.

CONCLUSION

Our study proposed novel targets for early-stage HCC treatment, laying the groundwork for improving treatment efficacy and prognosis of early-stage HCC patients.

Comparison of local ablative therapies, including radiofrequency ablation, microwave ablation, stereotactic ablative radiotherapy, and particle radiotherapy, for inoperable hepatocellular carcinoma: a systematic review and meta-analysis

Surgical intervention is the first-line treatment in well-selected hepatocellular carcinoma (HCC) patients. However, only a few patients are suitable to receive radical surgery. We conducted a systematic review and meta-analysis to evaluate local control among four local ablative therapies in inoperable HCC patients, including radiofrequency ablation therapy (RFA), microwave ablation therapy (MWA), stereotactic ablative radiotherapy (SABR), and particle radiotherapy. The primary outcome was the local control rate and the secondary were regional and distant progression rates, overall survival rate, and adverse events. We included twenty-six studies from PubMed, EMBASE, and Cochrane Library databases. MWA (p < 0.001) and particle radiotherapy (p < 0.001) showed better performance of local control compared to RFA, while SABR (p = 0.276) showed a non-significant trend. However, SABR (p = 0.002) and particle radiotherapy (p < 0.001) showed better performance than RFA in HCCs of ≥ 30 mm in size. MWA showed a similar result to RFA while SABR and particle radiotherapy showed a lower survival rate in the 2-, 3-, and 4-year overall survival rates. Our results indicate that MWA, SABR and particle radiotherapy were safe and no inferior to RFA in local control rate. Besides, the local control rates of SABR and particle radiotherapy are better than RFA in HCC of ≥ 30 mm in size. As a result, we suggested that MWA, SABR and particle radiotherapy to be effective alternatives to RFA for inoperable HCC. Moreover, the tumor size should be taken into consideration for optimal treatment selection between local ablative therapies.