Effect of cryoablation versus microwave ablation on clinical indices and cytokines in patients with hepatocellular carcinoma

Objective To investigate the changes in clinical indices and cytokines in peripheral blood after cryoablation or microwave ablation in patients with hepatocellular carcinoma (HCC) and related clinical significance. Methods A total of 62 patients with HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from June to December, 2018, were enrolled, and according to the treatment regimen, these patients were divided into cryoablation group with 30 patients and microwave ablation group with 32 patients. The two groups were compared in terms of routine blood test results [white blood cell count (WBC) , hemoglobin, and platelet count (PLT) ], liver function [alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , total bilirubin (TBil) , and albumin], coagulation function (international normalized ratio) , and peripheral blood cytokines [interleukin-2, tumor necrosis factor-α, interleukin-6 (IL-6) , interleukin-8, hepatocyte growth factor (HGF) , and vascular endothelial growth factor A (VEGFA) ]at 1 week before surgery and on day 2 after surgery. The chi-square test and the Fisher's exact test were used for comparison of categorical data between groups, and the t-test and the Mann-Whitney U test were used for comparison of continuous data between groups. Results Both groups had a significant increase in WBC and a significant reduction in PLT after surgery (cryoablation group: t =-7. 480 and-4. 280, both P < 0. 001; microwave ablation group:t =-5. 735 and-3. 075, both P < 0. 001) , and the cryoablation group had a significantly greater reduction in PLT than the microwave ablation group (Z =-4. 457, P <0. 001) . Both groups had significant increases in ALT, AST, and TBil after surgery (cryoablation group: Z =-4. 457, -4. 445, and-4. 229, all P < 0. 001; microwave ablation group: Z =-3. 617, -4. 703, and-4. 228, all P < 0. 001) , and the cryoab-lation group had significantly greater increases in ALT and AST than the microwave ablation group (Z =-3. 411 and-3. 829, both P <0. 001) . The cryoablation group had significant increases in IL-6, HGF, and VEGFA after surgery (Z =-4. 076, -4. 311, and-3. 123, all P < 0. 05) , with significantly greater increases than the microwave ablation group (Z =-2. 735, -2. 578, and-2. 201, all P <0. 05) . Conclusion Compared with microwave ablation, cryoablation can induce a higher level of acute inflammatory response within the short term after surgery, which may lead to higher rates of postoperative complications and tumor recurrence.