Incomplete thermal ablation is associated with intrahepatic spread of hepatocellular carcinoma and the miR-450a-2-3p/PIK3CA pathway

Incomplete thermal ablation contributes to the intrahepatic spread of hepatocellular carcinoma (HCC). The function of miR-450a-2-3p in treatment response to incomplete thermal ablation of HCC is unknown, despite its known tumor‑suppressive function. This research aims to examine the clinical significance and underlying mechanisms of miR-450a-2-3p in incomplete thermal ablation of HCC, thereby identifying therapeutic targets for preventing its intrahepatic spread. The study included 211 HCC patients treated with thermal ablation, of whom 36 had incomplete ablation. Serum miR-450a-2-3p levels were measured after ablation, and patients were followed up for 36 months to assess intrahepatic spread. Sublethal heat stress was applied to HCC cells, and cell proliferation, migration, and invasion were evaluated. Target validation was performed using bioinformatics analysis, dual-luciferase reporter assays, and rescue experiments. miR-450a-2-3p levels were markedly reduced in patients with incomplete ablation compared to those with complete ablation. Low miR-450a-2-3p levels were associated with intrahepatic spread in HCC patients. Both complete ablation and high miR-450a-2-3p expression were independent protective factors for HCC patients following ablation therapy. Heat stress downregulated miR-450a-2-3p and enhanced cell survival, migration, and invasion, whereas miR-450a-2-3p overexpression reversed these effects. PIK3CA was a direct target of miR-450a-2-3p, and PIK3CA overexpression attenuated the suppressive effects of miR-450a-2-3p. Incomplete ablation is related to intrahepatic spread of HCC and downregulation of miR-450a-2-3p. Serum miR-450a-2-3p may represent a promising non-invasive biomarker to explore in HCC patients following ablation therapy, and the miR-450a-2-3p/PIK3CA axis may offer a clue to treatment‑related mechanisms. Not applicable.