Abstract: Objective The purpose of this study was to investigate the clinical efficacy and safety of nanoknife irreversible electroporation (IRE) under ultrasound (US) guidance in the treatment of patients with unresectable hepatocellular carcinoma (nrHCC). Methods A total of 102 patients with nrHCC were encountered in our hospital between January 2021 and December 2024, and were assigned to undergo radiofrequency ablation (RFA) under US guidance in 51 cases in control, or undergo nanoknife IRE under US guidance in another 51 cases in observation. Serum alpha-fetoprotein (AFP) level was routinely detected, and peripheral blood lymphocyte subsets was determined by FCM. Results Objective remission rate and disease control rate in the observation group were 64.7% and 84.3%, both significantly higher than 41.2% and 64.7% (both P＜0.05) in the control group; by end of one month after treatment, serum AFP level in the observation group was (96.3±9.6)ng/mL,significantly lower than [(218.7±12.5)ng/mL,P＜0.05] in the control; percentages of peripheral blood CD3⁺ cells, CD4⁺ cells and CD4⁺/CD8⁺ cell ratio were (71.5±9.1)%, (40.7±6.5)% and (1.8±0.4), all significantly higher than [(62.4±8.8)%, (36.8±7.0)% and (1.4±0.3), respectively, P＜0.05], while percentage of CD8⁺ cells was (22.1±5.4)%, significantly lower than [(26.4±5.9)%, P＜0.05] in the control; by end of three month and six month after treatment, disease progression rates in the observation group were 2.0% and 5.9%, and in the control were 7.8%(P>0.05) and 21.6%(P＜0.05). Conclusion Nanoknife IRE under US guidance is short-termly effective in treatment of patients with nrHCC, which might improve body immune system functions.

Key words: Hepatocellular carcinoma, Nanoknife irreversible electroporation, Radiofrequency ablation, Ultrasound guidance, Lymphocyte subsets, Therapy