Objective To investigate the effectiveness and safety of nanoknife ablation guided by real-time virtual sonography (RVS) in the treatment of locally advanced pancreatic cancer (LAPC).Methods A retrospective analysis was performed for the clinical data of 27 patients with LAPC who attended The Fifth Affiliated Hospital of Zhengzhou University from April 2018 to October 2019, and according to the treatment method, the patients were divided into combination group (12 patients treated with IRE combined with chemotherapy) and control group (15 patients treated with chemotherapy alone). The chemotherapy regimen was gemcitabine combined with tegafur, gimeracil and oteracil potassium for both groups. Adverse reactions and complications were observed for the combination group during the perioperative period, and the two groups were compared in terms of the changes in myocardial enzymes, blood amylase, and carbohydrate antigen 19-9 (CA19-9) before treatment and at different time points after treatment, as well as remission rate (RR) and disease control rate (DCR) at 3 months after treatment and survival status during follow-up. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the Wilcoxon test was used for comparison within each group; the Fisher's exact test was used for comparison of categorical data between groups; the Kaplan-Meier method was used to analyze the survival status during follow-up.Results In the combination group, there were 12 cases of adverse reactions and mild complications during the perioperative period, i.e., 9 Clavien-Dindo grade Ⅰ cases and 3 grade Ⅱ cases. All patients in the combination group experienced a transient increase in myocardial enzymes, which returned to normal within 7 days, and there were no significant changes in creatine kinase and lactate dehydrogenase on day 7 after treatment (P > 0.05); 9 patients had a significant increase in blood amylase on day 1 after surgery, which significantly decreased on day 7 after surgery and basically returned to normal on day 14 after surgery, and there was no significant change in blood amylase on days 7、14, and 1 month after surgery (P > 0.05). Before treatment, the level of CA19-9 was higher than the normal value in both groups, and the combination group had a significant reduction in CA19-9 at 1, 2, and 3 months after treatment (all P < 0.05); in the control group, the level of CA19-9 firstly decreased for a short time and then increased, while there was no significant change in CA19-9 at 1, 2, and 3 months after treatment (all P > 0.05). At 3 months after treatment, the combination group had significantly higher RR and DCR than the control group (RR: 75.0% vs 26.7%, P=0.021; DCR: 91.6% vs 53.3%, P=0.043). During the median follow-up time of 13 months, compared with the control group, the combination group had significantly higher median progression-free survival time (10 months vs 5 months, P=0.014) and median overall survival time (18 months vs 10 months, P=0.034).Conclusion RVS-guided percutaneous nanoknife ablation has marked clinical effect and high safety in the treatment of LAPC and can be used as a new treatment option for patients who refuse or cannot tolerate laparotomy for ablation therapy.
本研究旨在通过分析2016年—2020年中国(不含港澳台地区)作者在SCIE(Science Citation Index Expanded)数据库收录的胃肠肝病学期刊发表的肝脏疾病研究的题录数据与来源期刊的特征，评价中国作者发表的肝脏疾病研究出版物特征的变化趋势，了解中国学者在肝脏疾病研究领域的贡献；通过计算被中国与全球作者发表在胃肠肝病学期刊上的肝脏疾病研究引用频次，为评价中国作者发表的肝脏疾病研究的国际与国内影响力提供证据。
Table
3.
The proportion of liver disease research published by Chinese authors in different divisions of Gastroenterology & Hepatology journals indexed in SCIE accounted for the change in the proportion of liver diseases research published in the same division in the world during 2016 to 2020
Table
4.
The research on liver diseases published by Chinese authors in the Gastroenterology & Hepatology journals indexed in SCIE was funded by the National Natural Science Foundation of China during 2016 to 2020
Figure
1.
The distribution of citation frequency of Chinese authors' published liver diseases research in Q1 Gastroenterology and Hepatology journals during 2016 to 2020
Table
5.
The liver disease research published by Chinese authors in the Gastroenterology & Hepatology journals indexed in SCIE was the 9 most frequently cited studies of liver disease research published by Chinese authors and global authors in the Gastroenterology & Hepatology journals during 2016 to 2020
题名
期刊
出版年
通信作者单位
TC(排名)
GC(排名)
LC(排名)
Development of Diagnostic Criteria and A Prognostic Score for Hepatitis B Virus-Related Acute- On-Chronic Liver Failure
GUT
2018
浙江大学医学院附属第一医院
74(54)
20(6)
20(1)
Serum Hepatitis B Virus RNA is Encapsidated Pregenome RNA that may be Associated with Persistence of Viral Infection and Rebound
J HEPATOL
2016
北京大学
191(13)
45(1)
19(2)
New Classification of Liver Biopsy Assessment for Fibrosis in Chronic Hepatitis B Patients Before and After Treatment
HEPATOLOGY
2017
首都医科大学附属北京友谊医院
59(76)
18(7)
13(3)
Covered Tips Versus Endoscopic Band Ligation Plus Propranolol for The Prevention of Variceal Rebleeding in Cirrhotic Patients with Portal Vein Thrombosis: A Randomised Controlled Trial
GUT
2018
空军军医大学西京医院
50(103)
16(9)
11(4)
Targeting Hepatic Traf1-Ask1 Signaling to Improve Inflammation, Insulin Resistance, And Hepatic Steatosis
J HEPATOL
2016
武汉大学
73(58)
14(12)
11(4)
Liver Transplantation for Hepatocellular Carcinoma Beyond the Milan Criteria
GUT
2016
浙江大学医学院附属第一医院
95(40)
21(5)
10(6)
Targeting Traf3 Signaling Protects Against Hepatic Ischemia/Reperfusions Injury
J HEPATOL
2016
武汉大学
59(76)
10(21)
10(6)
Perioperative Blood Transfusion Does Not Influence Recurrence-Free and Overall Survivals After Curative Resection for Hepatocellular Carcinoma A Propensity Score Matching Analysis
J HEPATOL
2016
海军军医大学附属东方肝胆外科医院
69(60)
13(15)
9(8)
Circular RNA Circmto1 Acts as The Sponge of Microrna-9 To Suppress Hepatocellular Carcinoma Progression
HEPATOLOGY
2017
浙江大学，海军军医大学
664(1)
10(22)
9(8)
Eight Millimetre Covered Tips Does Not Compromise Shunt Function but Reduces Hepatic Encephalopathy in Preventing Variceal Rebleeding
J HEPATOL
2017
空军军医大学西京医院
56(86)
22(4)
8(10)
……
……
……
……
……
……
……
Comparison of Laboratory Tests, Ultrasound, or Magnetic Resonance Elastography to Detect Fibrosis in Patients with Nonalcoholic Fatty Liver Disease: A Meta-Analysis
HEPATOLOGY
2017
华中科技大学同济医学院附属协和医院
238(9)
45(1)
7(12)
……
……
……
……
……
……
……
COVID-19: Abnormal Liver Function Tests
J HEPATOL
2020
南方科技大学第二附属医院
242(8)
26(3)
5(22)
Clinical Features of COVID-19-Related Liver Functional Abnormality
CLIN GASTROENTEROL HEPATOL
2020
复旦大学附属公共卫生临床中心
236(10)
17(8)
5(23)
注：J HEPATOL，Journal of Hepatology；CLIN GASTROENTEROL HEPATOL，Clinical Gastroenterology and Hepatology。
总被引频次可以用于评估出版物的影响力，但它假定所有引用的权重相同，具有明显的局限性。为了提高引文分析的可解释性，可以为引用加权，或者对施引文章和引用本身的特征进行限定[19]。胃肠肝病学期刊包括了肝病学专业期刊与消化病学专业期刊，其中Journal of Hepatology、Gut、Gastroenterology等高影响力期刊在全球享有盛誉。尽管中国作者也会在内科学期刊、医学综合期刊甚至多学科期刊发表肝脏疾病研究，但基本可以认为中国作者在专业期刊发表的肝脏疾病研究对于评价专科研究水平具有代表性，将来源期刊限定于胃肠肝病学期刊进行引文分析，有利于为认识肝脏疾病研究的影响力提供更加深入和巧妙的见解。
Pancreatic Cancer Committee of Chinese Anti-Cancer Association. Comprehensive guidelines for the diagnosis and treatment of pancreatic cancer (2018 version)[J]. J Clin Hepatol, 2018, 34(10): 2109-2120. DOI: 10.3969/j.issn.1001-5256.2018.10.011.
HE C, WANG J, ZHANG Y, et al. Comparison of combination therapies in the management of locally advanced pancreatic cancer: Induction chemotherapy followed by irreversible electroporation vs radiofrequency ablation[J]. Cancer Med, 2020, 9(13): 4699-4710. DOI: 10.1002/cam4.3119.
[3]
PAIELLA S, de PASTENA M, D'ONOFRIO M, et al. Palliative therapy in pancreatic cancer-interventional treatment with radiofrequency ablation/irreversible electroporation[J]. Transl Gastroenterol Hepatol, 2018, 3: 80. DOI: 10.21037/tgh.2018.10.05.
[4]
HAMMEL P, HUGUET F, van LAETHEM JL, et al. Effect of chemoradiotherapy vs chemotherapy on survival in patients with locally advanced pancreatic cancer controlled after 4 months of gemcitabine with or without erlotinib: The LAP07 randomized clinical trial[J]. JAMA, 2016, 315(17): 1844-1853. DOI: 10.1001/jama.2016.4324.
[5]
VROOMEN L, PETRE EN, CORNELIS FH, et al. Irreversible electroporation and thermal ablation of tumors in the liver, lung, kidney and bone: What are the differences?[J]. Diagn Interv Imaging, 2017, 98(9): 609-617. DOI: 10.1016/j.diii.2017.07.007.
[6]
VOGEL JA, van VELDHUISEN E, AGNASS P, et al. Time-dependent impact of irreversible electroporation on pancreas, liver, blood vessels and nerves: A systematic review of experimental studies[J]. PLoS One, 2016, 11(11): e0166987. DOI: 10.1371/journal.pone.0166987.
[7]
van ROESSEL S, KASUMOVA GG, VERHEIJ J, et al. International validation of the eighth edition of the American Joint Committee on Cancer (AJCC) TNM staging system in patients with resected pancreatic cancer[J]. JAMA Surg, 2018, 153(12): e183617. DOI: 10.1001/jamasurg.2018.3617.
[8]
LENCIONI R, LLOVET JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma[J]. Semin Liver Dis, 2010, 30(1): 52-60. DOI: 10.1055/s-0030-1247132.
[9]
RUARUS A, VROOMEN L, PUIJK R, et al. Locally advanced pancreatic cancer: A review of local ablative therapies[J]. Cancers (Basel), 2018, 10(1): 16. DOI: 10.3390/cancers10010016.
[10]
Chinese Society of Interventional and Minimally Invasive Therapy, China Medicine Education Association. Expert consensus on image-guided irreversible electroporation ablation for pancreatic cancer (2018 version)[J]. J Clin Hepatol, 2019, 35(2): 299-302. DOI: 10.3969/j.issn.1001-5256.2019.02.011
AL EFISHAT M, WOLFGANG CL, WEISS MJ. Stage Ⅲ pancreatic cancer and the role of irreversible electroporation[J]. BMJ, 2015, 350: h521. DOI: 10.1136/bmj.h521.
[12]
HOU JY, LIU RB, LIU Y, et al. The value of radiofrequency ablation in the special sites of the liver cancer by combining ultrasound guided with CT monitoring[J]. J Clin Radiol, 2012, 31(7): 1014-1017. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFS201207029.htm
BELFIORE MP, RONZA FM, ROMANO F, et al. Percutaneous CT-guided irreversible electroporation followed by chemotherapy as a novel neoadjuvant protocol in locally advanced pancreatic cancer: Our preliminary experience[J]. Int J Surg, 2015, 21(Suppl 1): s34-s39. DOI: 10.1016/j.ijsu.2015.06.049.
[14]
ZHANG Y, SHI J, ZENG J, et al. Percutaneous irreversible electroporation for ablation of locally advanced pancreatic cancer: Experience from a Chinese institution[J]. Pancreas, 2017, 46(2): e12-12e14. DOI: 10.1097/MPA.0000000000000703.
[15]
SCHEFFER HJ, VROOMEN LG, de JONG MC, et al. Ablation of locally advanced pancreatic cancer with percutaneous irreversible electroporation: Results of the Phase Ⅰ/Ⅱ PANFIRE Study[J]. Radiology, 2017, 282(2): 585-597. DOI: 10.1148/radiol.2016152835.
[16]
TONG H, LI XY, CHEN YJ, et al. Complications of nano-knife ablation on locally advanced pancreatic cancer[J]. Chin J Hepatobiliary Surg, 2020, 26(4): 270-271. DOI: 10.3760/cma.j.cn113884-20190923-00312.
MORIS D, MACHAIRAS N, TSILIMIGRAS DI, et al. Systematic review of surgical and percutaneous irreversible electroporation in the treatment of locally advanced pancreatic cancer[J]. Ann Surg Oncol, 2019, 26(6): 1657-1668. DOI: 10.1245/s10434-019-07261-7.
[18]
MARTIN RC 2nd, KWON D, CHALIKONDA S, et al. Treatment of 200 locally advanced (stage Ⅲ) pancreatic adenocarcinoma patients with irreversible electroporation: Safety and efficacy[J]. Ann Surg, 2015, 262(3): 486-494; discussion 492-494. DOI: 10.1097/SLA.0000000000001441.
[19]
YANG PC, HUANG KW, PUA U, et al. Prognostic factor analysis of irreversible electroporation for locally advanced pancreatic cancer-A multi-institutional clinical study in Asia[J]. Eur J Surg Oncol, 2020, 46(5): 811-817. DOI: 10.1016/j.ejso.2019.12.006.
CUI HL, XU L, LU T. Association of glucagon-like peptide-1 system with the prevention and treatment of nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2022, 38(6): 1406-1410. DOI: 10.3969/j.issn.1001-5256.2022.06.039.
CUI HL, XU L, LU T. Association of glucagon-like peptide-1 system with the prevention and treatment of nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2022, 38(6): 1406-1410. DOI: 10.3969/j.issn.1001-5256.2022.06.039.
Table
3.
The proportion of liver disease research published by Chinese authors in different divisions of Gastroenterology & Hepatology journals indexed in SCIE accounted for the change in the proportion of liver diseases research published in the same division in the world during 2016 to 2020
Table
4.
The research on liver diseases published by Chinese authors in the Gastroenterology & Hepatology journals indexed in SCIE was funded by the National Natural Science Foundation of China during 2016 to 2020
Table
5.
The liver disease research published by Chinese authors in the Gastroenterology & Hepatology journals indexed in SCIE was the 9 most frequently cited studies of liver disease research published by Chinese authors and global authors in the Gastroenterology & Hepatology journals during 2016 to 2020
题名
期刊
出版年
通信作者单位
TC(排名)
GC(排名)
LC(排名)
Development of Diagnostic Criteria and A Prognostic Score for Hepatitis B Virus-Related Acute- On-Chronic Liver Failure
GUT
2018
浙江大学医学院附属第一医院
74(54)
20(6)
20(1)
Serum Hepatitis B Virus RNA is Encapsidated Pregenome RNA that may be Associated with Persistence of Viral Infection and Rebound
J HEPATOL
2016
北京大学
191(13)
45(1)
19(2)
New Classification of Liver Biopsy Assessment for Fibrosis in Chronic Hepatitis B Patients Before and After Treatment
HEPATOLOGY
2017
首都医科大学附属北京友谊医院
59(76)
18(7)
13(3)
Covered Tips Versus Endoscopic Band Ligation Plus Propranolol for The Prevention of Variceal Rebleeding in Cirrhotic Patients with Portal Vein Thrombosis: A Randomised Controlled Trial
GUT
2018
空军军医大学西京医院
50(103)
16(9)
11(4)
Targeting Hepatic Traf1-Ask1 Signaling to Improve Inflammation, Insulin Resistance, And Hepatic Steatosis
J HEPATOL
2016
武汉大学
73(58)
14(12)
11(4)
Liver Transplantation for Hepatocellular Carcinoma Beyond the Milan Criteria
GUT
2016
浙江大学医学院附属第一医院
95(40)
21(5)
10(6)
Targeting Traf3 Signaling Protects Against Hepatic Ischemia/Reperfusions Injury
J HEPATOL
2016
武汉大学
59(76)
10(21)
10(6)
Perioperative Blood Transfusion Does Not Influence Recurrence-Free and Overall Survivals After Curative Resection for Hepatocellular Carcinoma A Propensity Score Matching Analysis
J HEPATOL
2016
海军军医大学附属东方肝胆外科医院
69(60)
13(15)
9(8)
Circular RNA Circmto1 Acts as The Sponge of Microrna-9 To Suppress Hepatocellular Carcinoma Progression
HEPATOLOGY
2017
浙江大学，海军军医大学
664(1)
10(22)
9(8)
Eight Millimetre Covered Tips Does Not Compromise Shunt Function but Reduces Hepatic Encephalopathy in Preventing Variceal Rebleeding
J HEPATOL
2017
空军军医大学西京医院
56(86)
22(4)
8(10)
……
……
……
……
……
……
……
Comparison of Laboratory Tests, Ultrasound, or Magnetic Resonance Elastography to Detect Fibrosis in Patients with Nonalcoholic Fatty Liver Disease: A Meta-Analysis
HEPATOLOGY
2017
华中科技大学同济医学院附属协和医院
238(9)
45(1)
7(12)
……
……
……
……
……
……
……
COVID-19: Abnormal Liver Function Tests
J HEPATOL
2020
南方科技大学第二附属医院
242(8)
26(3)
5(22)
Clinical Features of COVID-19-Related Liver Functional Abnormality
CLIN GASTROENTEROL HEPATOL
2020
复旦大学附属公共卫生临床中心
236(10)
17(8)
5(23)
注：J HEPATOL，Journal of Hepatology；CLIN GASTROENTEROL HEPATOL，Clinical Gastroenterology and Hepatology。
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