Fig. 8: CD36^hi-EM-CTC detection assists in the early identification of iRFA.

A Treatment timeline for a representative CRLM patient. The patient underwent Dixon surgery following CRLM diagnosis. First tumor evaluation showed a new metastasis in liver S5, and subsequently, RFA was performed. Postoperative PET/CT showed no tumor viability. Intrahepatic S7 metastasis appeared 4 months later. S5 and S7 tissues were obtained through hepatic resection, and pathological examination as well as sequencing were performed. The second progression with new lung metastases occurred at 7 months. Triangles: liver or lung metastases. B Neutrophil infiltration levels in tumors pre- and post-iRFA analyzed by different datasets (Box center line: median; box limits: upper and lower quartiles; whiskers: 1.5× interquartile range). C Representative GSEA analysis of FA metabolism and the PPAR pathway, and the differences in scRNA-seq data between pre- and post-iRFA tumors. Kolmogorov-Smirnov test. FDR correction. D CD36 and CXCL5 staining of the tumors pre- and post-iRFA. E Density quantification of CD36⁺ and CXCL5⁺ areas in the tumors pre- and post-iRFA. F CD66b immunofluorescence in tumors pre- and post-iRFA. Scale bars, 50 μm and 10 μm. CD66b⁺ neutrophil counts shown on the left. G MPO and cit-H3 immunofluorescence in tumors pre- and post-iRFA. Scale bars, 50 μm. The cit-H3⁺ area shown on the left. H Mesenchymal markers, epithelial markers, and CD36 immunofluorescence on CTCs were analyzed. The data represented the proportions of CD36^hi-CTCs, CD36^hi-E-CTCs, and CD36^hi-EM-CTCs in the tumors pre- and post-iRFA. Scale bars, 10 μm. I MPO-dsDNA levels in the peripheral blood pre- and post-iRFA. J The data represented the proportions of CD36^hi-CTCs and CD36^hi-EM-CTCs in the cRFA and iRFA tumors. K MPO-dsDNA levels in the peripheral blood of cRFA and iRFA patients. Data are presented as mean values ± SD; Statistical analysis was performed based on Paired t-test (B, E, F, and G, n = 8 patients; H and I, n = 13 patients) or Unpaired two-sided t-test (J, K); cRFA, n = 5 patients, iRFA, n = 13 patients). Source data are provided as a Source Data file.