术后辅助经导管动脉化疗栓塞（PA-TACE）可以使伴有微血管侵犯（MVI）的肝细胞癌（HCC）患者获得更长的总生存期（OS）和无病生存期（DFS）。我们研究了这种治疗策略是否可以通过调节功能失调的免疫状态使这些患者受益。因此，我们进行了一项回顾性队列研究，通过测量辅助性T细胞17（Th17）和调节性T细胞（Treg）的水平来探讨早期PA-TACE对伴有MVI的HCC患者的效果。该研究回顾性纳入了472例HCC患者纳入2015年12月至2018年12月期间接受肝切除术、术后病理证实的MVI患者115例，根据是否行TACE分为TACE组和非TACE组两组。患有 MVI 的 HCC 患者。 TACE前1天和TACE后4周测定外周血中Treg细胞和Th17细胞的比例。对两组所有患者进行随访直至死亡或直至研究于 2023 年 12 月结束。比较仅接受肝切除术和早期 PA 的 MVI 患者的 OS 率和无进展生存率 (PFS) -TACE。在来自 472 名患者的 115 名患有 MVI 的 HCC 患者中，该研究将 51 名接受 PA-TACE 的患者纳入 TACE 组，将 42 名未接受 TACE 的患者纳入非 TACE 组。两组基线数据差异无统计学意义（均P>0.05）。 PA-TACE治疗后HCC患者CD4 T细胞中Treg频率显着低于基线（7.34%±3.61% vs. 5.82%±2.76%，P<0.001），而这些患者CD4 T细胞中Th17频率显着低于基线（7.34%±3.61% vs. 5.82%±2.76%，P<0.001）。患者的死亡率显着高于基线（0.49%±0.28% vs. 0.50%±0.25%，P<0.001）。所有患者的中位 OS 为 61.8 个月。 TACE组12、36、60个月的OS率和PFS率均显着高于非TACE组（均P<0.05）。PA-TACE可能具有改善生存结局、恢复免疫功能的作用。肝切除术后 MVI 的 HCC 患者的体内平衡。2024 年胃肠肿瘤学杂志。版权所有。

Postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) can achieve longer overall survival (OS) and disease-free survival (DFS) in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI). We investigated whether this treatment strategy could benefit these patients by mediating the dysfunctional immunological status. Therefore, a retrospective cohort study was conducted to investigate the effect of early PA-TACE in HCC patients with MVI by measuring the levels of T helper cell 17 (Th17) and regulatory T cell (Treg).This study retrospectively included 472 patients with HCC undergoing hepatectomy between December 2015 and December 2018, and 115 patients with MVI confirmed by postoperative pathology were enrolled and divided into two groups of TACE group and non-TACE group according to whether TACE was performed. HCC patients with MVI. The proportion of Treg and Th17 cells in peripheral blood was measured one day before and four weeks after TACE. All patients in the two groups were followed up until death or until the study ended in December 2023. The rates of OS and progression-free survival (PFS) in patients with MVI were compared between those who received hepatectomy alone and those who underwent early PA-TACE.Among 115 HCC patients with MVI from 472 patients, the study enrolled 51 patients with PA-TACE into the TACE group and 42 patients without TACE into the non-TACE group. There were no statistical differences in baseline data between the two groups (all P>0.05). The frequency of Treg among CD4+ T cells in HCC patients with PA-TACE was significantly lower than baseline (7.34%±3.61% vs. 5.82%±2.76%, P<0.001), and the frequency of Th17 among CD4+ T cells in these patients was significantly higher than baseline (0.49%±0.28% vs. 0.50%±0.25%, P<0.001). Among all the patients, the median OS was 61.8 months. The OS rate and PFS rate at 12, 36, and 60 months in the TACE group were significantly higher than those in the non-TACE group (all P<0.05).PA-TACE may have roles in improving survival outcomes, and restoring immune homeostasis in HCC patients with MVI after hepatectomy.2024 Journal of Gastrointestinal Oncology. All rights reserved.