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已发表论文
肝细胞癌患者接受 TACE、免疫治疗及贝伐珠单抗联合治疗后发生胃胸瘘：1 例报告
Authors Xu X, Li J, Pan L, Yu H, Huang J
Received 15 August 2025
Accepted for publication 26 November 2025
Published 3 December 2025 Volume 2025:12 Pages 2671—2677
DOI https://doi.org/10.2147/JHC.S560287
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Jörg Trojan
Xin Xu, Jingjing Li, Lanyue Pan, Haijing Yu,* Jiaquan Huang*
Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jiaquan Huang, Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou, Wuhan, Hubei, 430030, People’s Republic of China, Email huangjiaquan21@aliyun.com Haijing Yu, Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou, Wuhan, Hubei, 430030, People’s Republic of China, Email 463104640@qq.com
Abstract: Gastropleural fistula (GPF) is an extremely rare complication after treatment for liver cancer. We report a case of a 54-year-old man with hepatitis B virus (HBV)-related liver cancer who developed a GPF after multiple sessions of transarterial chemoembolization (TACE) combined with immunotherapy and targeted therapy. During the third treatment, because of arterial remodeling and changes in tumor vascular supply, the embolization route was changed to the left inferior phrenic artery. After the procedure, the patient presented with abdominal pain, chest pain, and fever. Metagenomic next-generation sequencing (mNGS) of the pleural effusion identified Porphyromonas endodontalis, and Pneumocystis jirovecii was also detected in the sputum. Upper gastrointestinal endoscopy and water-soluble contrast radiography confirmed a gastric fundus perforation with a fistulous communication to the pleural cavity. After multidisciplinary evaluation, the patient underwent laparoscopic fistula repair and had a favorable postoperative recovery. This case highlights that, while the combination of TACE, immunotherapy, and targeted agents may provide synergistic antitumor benefits, it also carries a potential risk of serious gastric complications.
Keywords: liver cancer, TACE, sintilimab, bevacizumab, gastropleural fistula, adverse event, case report
Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jiaquan Huang, Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou, Wuhan, Hubei, 430030, People’s Republic of China, Email huangjiaquan21@aliyun.com Haijing Yu, Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou, Wuhan, Hubei, 430030, People’s Republic of China, Email 463104640@qq.com
Abstract: Gastropleural fistula (GPF) is an extremely rare complication after treatment for liver cancer. We report a case of a 54-year-old man with hepatitis B virus (HBV)-related liver cancer who developed a GPF after multiple sessions of transarterial chemoembolization (TACE) combined with immunotherapy and targeted therapy. During the third treatment, because of arterial remodeling and changes in tumor vascular supply, the embolization route was changed to the left inferior phrenic artery. After the procedure, the patient presented with abdominal pain, chest pain, and fever. Metagenomic next-generation sequencing (mNGS) of the pleural effusion identified Porphyromonas endodontalis, and Pneumocystis jirovecii was also detected in the sputum. Upper gastrointestinal endoscopy and water-soluble contrast radiography confirmed a gastric fundus perforation with a fistulous communication to the pleural cavity. After multidisciplinary evaluation, the patient underwent laparoscopic fistula repair and had a favorable postoperative recovery. This case highlights that, while the combination of TACE, immunotherapy, and targeted agents may provide synergistic antitumor benefits, it also carries a potential risk of serious gastric complications.
Keywords: liver cancer, TACE, sintilimab, bevacizumab, gastropleural fistula, adverse event, case report