超声波广泛应用于癌症的诊断和治疗。肿瘤可以通过热或机械组织消融来治疗。此外，可以通过热疗、声动力疗法和声孔作用来操纵肿瘤，例如通过增加肿瘤灌注或生物屏障的渗透性来增强药物递送。这些治疗在肿瘤中诱导各种免疫反应。然而，实验设置之间的相互矛盾的数据和高度异质性使得很难概括超声对肿瘤免疫的影响。因此，我们进行了系统评价来回答这个问题：“与没有超声的对照条件相比，超声是否会改变人类和动物外周实体瘤的免疫反应？”在 PubMed、EMBASE 和 Web of Science 中进行了系统的文献检索，并确定了 24,401 篇可能相关的出版物。其中，96 篇出版物有资格纳入系统评价。实验在人类、大鼠和小鼠中进行，重点针对不同的肿瘤类型，主要是乳腺癌和黑色素瘤。我们收集了有关热超声和非热超声设置、声波增敏剂或声波增强器的使用以及抗肿瘤治疗的数据。进行了六项荟萃分析，以量化超声对 T 细胞（细胞毒性 T 细胞、辅助 T 细胞和调节性 T 细胞）肿瘤浸润以及血液细胞因子（白细胞介素 6、干扰素 γ、肿瘤坏死因子 α）的影响。我们提供了强有力的科学证据，证明超声波可以改变 T 细胞浸润到肿瘤中并增加血液细胞因子浓度。此外，我们还根据肿瘤类型、超声设置和小鼠年龄确定了免疫细胞浸润的显着差异。使用热疗与声敏剂相结合并在年轻小鼠中观察到更强的效果。由于大多数癌症患者年龄较大，后者可能会损害研究结果的转化影响。因此，我们的结果可能有助于完善超声参数，以增强治疗用途的抗肿瘤免疫反应，并最大限度地减少诊断应用中的免疫效应。版权所有 © 2024。由 Elsevier B.V. 出版。

Ultrasound is widely used in the diagnosis and therapy of cancer. Tumors can be treated by thermal or mechanical tissue ablation. Furthermore, tumors can be manipulated by hyperthermia, sonodynamic therapy and sonoporation, e.g., by increasing tumor perfusion or the permeability of biological barriers to enhance drug delivery. These treatments induce various immune responses in tumors. However, conflicting data and high heterogeneity between experimental settings make it difficult to generalize the effects of ultrasound on tumor immunity. Therefore, we performed a systematic review to answer the question: "Does ultrasound alter the immune reaction of peripheral solid tumors in humans and animals compared to control conditions without ultrasound?" A systematic literature search was performed in PubMed, EMBASE, and Web of Science and 24,401 potentially relevant publications were identified. Of these, 96 publications were eligible for inclusion in the systematic review. Experiments were performed in humans, rats, and mice and focused on different tumor types, primarily breast and melanoma. We collected data on thermal and non-thermal ultrasound settings, the use of sono-sensitizers or sono-enhancers, and anti-tumor therapies. Six meta-analyses were performed to quantify the effect of ultrasound on tumor infiltration by T cells (cytotoxic, helper, and regulatory T cells) and on blood cytokines (interleukin-6, interferon-γ, tumor necrosis factor-α). We provide robust scientific evidence that ultrasound alters T cell infiltration into tumors and increases blood cytokine concentrations. Furthermore, we identified significant differences in immune cell infiltration based on tumor type, ultrasound settings, and mouse age. Stronger effects were observed using hyperthermia in combination with sono-sensitizers and in young mice. The latter may impair the translational impact of study results as most cancer patients are older. Thus, our results may help refining ultrasound parameters to enhance anti-tumor immune responses for therapeutic use and to minimize immune effects in diagnostic applications.Copyright © 2024. Published by Elsevier B.V.