肝细胞癌超声诊疗基础研究进展:从诊断、治疗到诊疗一体化
DOI: 10.12449/JCH260702
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:汪思睿、顾卫琪负责撰写论文初稿;沈玉婷、尹豪豪负责论文的修改完善;徐辉雄负责指导文章思路并审阅定稿。
Advances in basic research on ultrasound diagnosis and treatment of hepatocellular carcinoma: From diagnosis and treatment to integrated management
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摘要: 肝细胞癌(HCC)的精准诊疗面临肿瘤微环境复杂、治疗抵抗及易复发转移等重大挑战。近年来,超声技术已突破传统筛查定位功能,逐渐发展为兼具能量激活、靶向递送、局部消融、免疫调控和疗效反馈能力的多维治疗平台。本文系统综述了超声技术在HCC治疗及诊疗一体化基础研究中的最新进展。在治疗方面,以微泡/纳泡递送、声动力疗法、高强度聚焦超声及组织碎化术为代表的干预策略,不仅实现了病灶的原位物理毁损,更通过与声遗传学、代谢重编程及免疫化疗的深度协同,有效逆转了肿瘤的免疫耐受网络。在诊疗一体化方面,新型声敏纳米递送系统构筑了能量激活与靶向控释的平台。针对该领域面临的转化瓶颈,建议未来建立标准化的临床前治疗声学参数共识,以期为HCC的个体化精准诊疗确立新的转化范式。Abstract: The precise diagnosis and treatment of hepatocellular carcinoma (HCC) face major challenges such as the complexity of tumor microenvironment, treatment resistance, and a high risk of recurrence and metastasis. In recent years, ultrasound technology has moved beyond its traditional role in screening and localization, gradually evolving into a multidimensional therapeutic platform capable of energy activation, targeted delivery, local ablation, immune modulation, and therapeutic feedback. This article systematically reviews the latest advances in the basic research on ultrasound techniques in HCC treatment and integrated management. In terms of treatment, intervention strategies represented by microbubble/nanobubble-mediated delivery, sonodynamic therapy, high-intensity focused ultrasound, and histotripsy not only enable in situ physical destruction of lesions, but also effectively reverse tumor immune tolerance networks through deep synergy with sonogenetics, metabolic reprogramming, and immunochemotherapy. In terms of integrated management, novel sonosensitive nanodelivery systems provide a platform for energy activation and targeted controlled release. To address the translational bottlenecks in this field, it is recommended to develop standardized consensus on preclinical therapeutic ultrasound parameters, in order to establish a new translational paradigm for individualized precise diagnosis and treatment of HCC.
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