Liver Tumor Microenvironment Remodeling Promotes Hepatocellular Carcinoma Progression

November 8, 2026 updated by: The Fourth Affiliated Hospital of Zhejiang University School of Medicine

Hepatocellular carcinoma (HCC) is a highly prevalent malignancy worldwide. Although radiofrequency ablation (RFA) is widely used for the treatment of early-stage small HCC, its 5-year recurrence rate reaches up to 70%, significantly higher than that of surgical resection, suggesting that the tumor microenvironment (TME) plays a critical role in the progression of residual tumors. Notably, in the context of non-alcoholic fatty liver disease (NAFLD), HCC patients with concurrent fatty liver have an even higher risk of post-RFA recurrence and metastasis, yet the underlying mechanisms remain unclear. Recent studies have shown that extracellular vesicles (EVs), as important mediators of intercellular communication, are abundantly released in the fatty liver microenvironment. By carrying bioactive molecules such as proteins and nucleic acids, EVs remodel the TME and promote HCC cell proliferation, migration, and immune evasion. However, how fatty liver-derived EVs specifically regulate the malignant progression of residual tumors and reshape the immune and metabolic microenvironment under conditions of local thermal stress and ischemia-hypoxia following RFA remains poorly understood. Based on these findings, this project proposes the scientific hypothesis that abnormally released EVs in the fatty liver microenvironment promote post-RFA tumor progression by remodeling the TME and inducing residual HCC cells to acquire a more aggressive phenotype. Elucidating this mechanism is of great significance for understanding the causes of high post-RFA recurrence in the context of fatty liver, identifying potential biomarkers, and developing novel adjuvant therapeutic strategies.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Clinical data of patients undergoing radiofrequency ablation of liver cancer in the Fourth Affiliated Hospital of Zhejiang University were collected

Description

Inclusion Criteria:

HCC Patient Inclusion Criteria:

Patients with hepatocellular carcinoma (HCC) who meet the following criteria were included: solitary tumor diameter ≤ 5 cm; for multiple tumors, no more than 3 lesions with each tumor diameter ≤ 3 cm, and no evidence of extrahepatic metastasis; Child-Pugh class A or B; absence of refractory ascites or uncorrectable coagulation dysfunction; prothrombin activity > 40% and platelet count > 500,000/L.

Fatty Liver Disease Inclusion Criteria:

Patients were diagnosed with fatty liver disease based on the following criteria: imaging evidence of fatty liver and/or liver biopsy demonstrating ≥5% macrovesicular steatosis of hepatocytes; presence of one or more components of metabolic syndrome; and exclusion of other potential causes of fatty liver, including excessive alcohol consumption, malnutrition, and Wilson's disease.

Exclusion Criteria:

HCC Patient Exclusion Criteria:

Patients were excluded if they presented with vascular invasion or extrahepatic metastasis, severe coagulation disorders, severe cardiopulmonary insufficiency, or uncontrolled hepatic decompensation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: CASE_CONTROL
  • Time Perspectives: PROSPECTIVE

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
treatment after RFA

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
progression-free survival
Time Frame: 1 years after RFA traeatment
1 years after RFA traeatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
The Fourth Affiliated Hospital of Zhejiang University School of Medicine

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 30, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 30, 2030

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 30, 2030

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 13, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 13, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • KY-2026-116

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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