Pulsed Focused Ultrasound Stimulates the Release of Tumor Biomarkers into the Blood Circulation.
Pulsed Focused Ultrasound Stimulates the Release of Tumor Biomarkers into the Blood Circulation.
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DOI：
10.1148/radiol.2017171654
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发表时间：
2017-11
期刊：
影响因子：
19.7
通讯作者：
H. Pan;Wenbin Zhou;Shui Wang
中科院分区：
文献类型：
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作者：
H. Pan;Wenbin Zhou;Shui Wang
首先，Chevillet博士及其同事认为脉冲聚焦超声是安全的，因为它通过刺激抗肿瘤免疫反应来抑制肿瘤生长和转移。据报道，在3.3 MHz下操作的聚焦超声可引发抗肿瘤免疫反应（4），但本研究中使用的1.5 MHz的风险尚未研究。此外，亚致死温度（42-47 ℃）的热处理可促进肿瘤生长和进展（5，6）。未提供研究治疗期间肿瘤组织的病灶温度。需要更多的信息来确定这种方法的安全性。其次，Chevillet博士及其同事观察到，在脉冲聚焦超声照射下，血浆中miRNA生物标志物的丰度增加了3倍至32倍。据报道，miRNA在血浆中稳定，并显示出作为诊断和/或预后生物标志物的潜力（7）。我们想知道脉冲聚焦超声诱导的高水平血浆miRNA是否具有与肿瘤自然分泌的血浆miRNA水平相同的预后价值。此外，当这种方法重复用于监测治疗反应时，可能难以确定miRNA水平的变化是否有助于治疗反应或肿瘤异质性。第三，在脉冲聚焦超声治疗期间，肿瘤细胞和周围的基质细胞都被破坏。miRNA可以从肿瘤细胞和/或基质细胞引发。目前还不确定这两种类型细胞的释放是否总是具有相同的临床意义，以及如何区分它们。
First, Dr Chevillet and colleagues suggested that pulsed focused ultrasound is safe because it suppresses tumor growth and metastases by stimulating an antitumor immune response. Focused ultrasound operated at 3.3 MHz was reported to elicit antitumor immune response (4), but the risk of 1.5 MHz used in this study has not been investigated. Besides, heat treatment with sublethal temperature (42–47 C) can promote tumor growth and progression (5, 6). The focal temperature in the tumor tissue during treatment in the study was not provided. More information is needed to determine the safety of this approach. Second, Dr Chevillet and colleagues observed that there was a threefold to 32-fold increase in the abundance of miRNA biomarkers in the plasma with pulsed focused ultrasound exposure. It was reported that miRNAs were stable in the plasma and showed the potential to serve as diagnostic and/or prognostic biomarkers (7). We wonder whether the high level of plasma miRNA elicited with pulsed focused ultrasound possesses the same prognostic value as the level of plasma miRNA secreted by tumor naturally. Additionally, when this approach is used repeatedly for monitoring treatment response, it may be difficult to determine whether the changes in the level of miRNAs contribute to treatment response or tumor heterogeneity. Third, both tumor cells and the surrounding stromal cells are disrupted during pulsed focused ultrasound treatment. miRNAs may be elicited from tumor cells and/or stromal cells. It is uncertain whether release from both types of cells always has the same clinical significance and how to distinguish between them.