ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Risk Factors and Immune Landscape of Early Local Tumor Progression after Microwave Ablation for Lung Cancer: A Retrospective Nested Case-control Study
Nan Wang
Jingwen Xu
Ji Ma
Siyi Niu
Xiuhong Ren
Qi Xie
Zhigang Wei
Xin Ye
Shandong Provincial Qianfoshan Hospital, Jinan, China
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Abstract
Background and Objectives: Microwave ablation (MWA) is an effective therapy for early-stage inoperable non-small cell lung cancer (NSCLC), yet its efficacy is limited by early local tumor progression (LTP). As early LTP is often suggestive of incomplete ablation, this study aimed to identify its risk factors and to characterize the associated changes in systemic immune parameters. Methods: This single-center retrospective nested case-control study enrolled patients with NSCLC who underwent MWA between January 1, 2021, and December 31, 2023. Patients were divided into an early LTP group (LTP ≤6 months post-MWA) and a control group. Clinical data and peripheral blood immune parameters at pre-MWA, one-week post-MWA, and one-month post-MWA were collected. Univariate and multivariate logistic regression analyses were used to identify independent risk factors and dynamic changes in immune indicators compared between groups. Results: A total of 76 patients were included (19, early LTP group; 57, control group). Multivariate analysis identified three independent risk factors for early LTP: maximum tumor diameter >30 mm (OR = 2.681, 95%CI: 1.218–5.901, P = 0.014), distance to hilum ≤10 mm (OR = 3.280, 95%CI: 1.678–6.411, P = 0.001), and ablative safety margin (≤5.0 mm) (OR = 4.152, 95%CI: 1.922–8.968, P < 0.001). Comparative analysis of peripheral blood immune parameters revealed distinct patterns between groups at one-month post-MWA. Compared to the control group, the early LTP group exhibited a significant reduction in CD4⁺ T cells (P = 0.040) and IL-2 levels (P = 0.020), whereas IL-10 (P < 0.001) and IL-6 (P = 0.004) levels were significantly elevated. Conclusion: Large tumor size, proximity to the pulmonary hilum, and an insufficient ablative safety margin are key risk factors for early LTP post-MWA. The development of early LTP is associated with significant alterations in specific peripheral blood immune cell subsets and cytokine levels at one-month post-MWA.
Summary
Keywords
immune microenvironment, incomplete microwave ablation, Local tumor progression, lung cancer, Risk factors
Received
14 December 2025
Accepted
19 February 2026
Copyright
© 2026 Wang, Xu, Ma, Niu, Ren, Xie, Wei and Ye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xin Ye
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