{"id":4727,"date":"2022-11-11T09:29:26","date_gmt":"2022-11-11T01:29:26","guid":{"rendered":"http:\/\/dh.oncolab.cn\/index.php\/2022\/11\/11\/%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac35%e7%ab%a0%ef%bc%9a%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6\/"},"modified":"2022-11-11T09:29:26","modified_gmt":"2022-11-11T01:29:26","slug":"%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac35%e7%ab%a0%ef%bc%9a%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6","status":"publish","type":"post","link":"http:\/\/dh.oncolab.cn\/index.php\/2022\/11\/11\/%e5%85%8d%e7%96%ab%e5%ad%a6%e6%8b%be%e9%81%97-%e7%ac%ac35%e7%ab%a0%ef%bc%9a%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6\/","title":{"rendered":"\u514d\u75ab\u5b66\u62fe\u9057-\u7b2c35\u7ae0\uff1a\u80bf\u7624\u514d\u75ab\u5b66"},"content":{"rendered":"
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\u672c\u7ae0\u4ecb\u7ecd\u80bf\u7624\u514d\u75ab\u5b66\u76f8\u5173\u5185\u5bb9\uff0c\u4e3b\u8981\u5305\u62ec\uff1a1\uff09\u9057\u4f20\u56e0\u7d20\u53ca\u75c5\u539f\u4f53\u4e0e\u6dcb\u5df4\u7ec6\u80de\u7684\u76f8\u4e92\u4f5c\u7528\u5982\u4f55\u5bfc\u81f4\u6dcb\u5df4\u7ec6\u80de\u7624\uff1b2\uff09\u514d\u75ab\u7cfb\u7edf\u5982\u4f55\u5bf9\u80bf\u7624\u4f5c\u51fa\u5e94\u7b54\u4ee5\u53ca\u65b0\u7684\u80bf\u7624\u514d\u75ab\u7597\u6cd5\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6dcb\u5df4\u7cfb\u7edf\u80bf\u7624<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5f71\u54cd\u9002\u5e94\u6027\u514d\u75ab\u7cfb\u7edf\u7684\u6076\u6027\u6dcb\u5df4\u7624\u8d77\u6e90\u4e8e\u5355\u4e2a\u6dcb\u5df4\u7ec6\u80de\u6216\u6d46\u7ec6\u80de\u3002\u6076\u6027\u6dcb\u5df4\u7624\u7684\u6bcf\u4e2a\u7ec6\u80de\u90fd\u7ecf\u5386\u4e86\u76f8\u540c\u7684\u514d\u75ab\u53d7\u4f53\u57fa\u56e0\u7684\u91cd\u6392\uff0c\u5e76\u8868\u8fbe\u76f8\u540c\u7684\u514d\u75ab\u7403\u86cb\u767d\u6216T\u7ec6\u80de\u53d7\u4f53(TCR)\u5206\u5b50\uff0c\u8fd9\u4e9b\u76f8\u540c\u6027\u8d28\u7684\u7ec6\u80de\u79f0\u4e3a\u5355\u514b\u9686\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6dcb\u5df4\u7cfb\u7edf\u6076\u6027\u80bf\u7624\u7684\u7ec6\u80de\u8d77\u6e90\u5982Fig.35.1<\/span>\u6240\u793a\uff0c\u80bf\u7624\u7ec6\u80de\u7684\u7279\u5f81\u5982Table.35.1<\/span>\u6240\u793a\u3002\u6bcf\u79cd\u80bf\u7624\u7684\u7279\u5f81\u7531\u8d77\u6e90\u7ec6\u80de\u7684\u751f\u7269\u5b66\u7279\u6027\u51b3\u5b9a\u3002\u4f8b\u5982\uff0c\u6025\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5(ALL)\u6e90\u4e8e\u5feb\u901f\u5206\u88c2\u7684\u524d\u4f53B\u7ec6\u80de\uff0c\u5177\u6709\u6781\u5f3a\u7684\u4fb5\u88ad\u6027\uff0c\u82e5\u60a3\u8005\u4e0d\u63a5\u53d7\u6cbb\u7597\u53ef\u80fd\u5728\u8bca\u65ad\u540e\u6570\u5468\u5185\u6b7b\u4ea1\u3002\u800c\u9aa8\u9ad3\u7624\u8d77\u6e90\u4e8e\u5206\u6ccc\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\u4e14\u751f\u957f\u3001\u6210\u719f\u7f13\u6162\u7684\u6d46\u7ec6\u80de\uff0c\u6545\u9aa8\u9ad3\u7624\u60a3\u8005\u4e0d\u52a0\u6cbb\u7597\u4e5f\u53ef\u5b58\u6d3b\u6570\u5e74\u3002<\/p>\n

\u56e0\u4e3a\u6dcb\u5df4\u7cfb\u7edf\u6076\u6027\u80bf\u7624\u7ec6\u80de\u5f88\u5bb9\u6613\u63d0\u53d6\u5e76\u5728\u4f53\u5916\u57f9\u517b\uff0c\u6240\u4ee5\u5b83\u4eec\u7684\u5f62\u6210\u673a\u5236\u7814\u7a76\u5df2\u8f83\u4e3a\u660e\u6670\uff0c\u901a\u5e38\u662f\u67d3\u8272\u4f53\u6613\u4f4d\u6216\u75c5\u539f\u4f53\u4f5c\u7528\u6fc0\u6d3b\u764c\u57fa\u56e0\u7684\u7ed3\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 35.1<\/span> \u6dcb\u5df4\u7cfb\u7edf\u6076\u6027\u80bf\u7624\u7684\u6765\u6e90\u3002\u80bf\u7624\u7ec6\u80de\u901a\u5e38\u5728\u9aa8\u9ad3\u6216\u6dcb\u5df4\u7ed3\u4e2d\u51fa\u73b0\uff0c\u4f46\u53ef\u80fd\u6269\u6563\u5230\u8840\u6db2\u6216\u5176\u4ed6\u7ec4\u7ec7\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Table.35.1<\/span> \u6dcb\u5df4\u7cfb\u7edf\u6076\u6027\u80bf\u7624\u53ca\u5176\u7279\u5f81<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u80bf\u7624\u7684\u5f62\u6210<\/span><\/strong><\/p>\n<\/section>\n

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\u67d3\u8272\u4f53\u6613\u4f4d<\/span><\/strong><\/p>\n

\u5728\u514d\u75ab\u53d7\u4f53\u57fa\u56e0\u91cd\u6392\u8fc7\u7a0b\u4e2d\uff0c\u67d3\u8272\u4f53\u7684\u65ad\u88c2\u53ef\u80fd\u65e0\u6cd5\u6b63\u786e\u4fee\u590d\u3002\u5728B\u7ec6\u80de\u4e2d\uff0c\u67d3\u8272\u4f53\u65ad\u88c2\u4e5f\u4f1a\u5728\u7c7b\u522b\u8f6c\u6362\u671f\u95f4\u53d1\u751f\u3002\u4e0d\u540c\u67d3\u8272\u4f53\u7684\u7247\u6bb5\u5076\u5c14\u4f1a\u805a\u5728\u4e00\u8d77\u3002\u8fd9\u4e9b\u5bf9\u6dcb\u5df4\u7ec6\u80de\u901a\u5e38\u4f1a\u4ea7\u751f\u4e25\u91cd\u7684\u5f71\u54cd\u3002\u7136\u800c\uff0c\u4e00\u4e9b\u7f55\u89c1\u7684\u67d3\u8272\u4f53\u6613\u4f4d\u5bf9\u7ec6\u80de\u5b58\u6d3b\u6709\u7740\u79ef\u6781\u7684\u5f71\u54cd\u3002\u8fd9\u53ef\u80fd\u662f\u56e0\u4e3a\u5e26\u6709\u514d\u75ab\u7403\u86cb\u767d\u57fa\u56e0\u542f\u52a8\u5b50\u6216\u589e\u5f3a\u5b50\u7684\u764c\u57fa\u56e0\u6613\u4f4d\u53ef\u4ee5\u5bfc\u81f4\u764c\u57fa\u56e0\u7684\u6c38\u4e45\u6fc0\u6d3b\u3002<\/p>\n

\u5728\u67d0\u4e9b\u7c7b\u578b\u7684\u6dcb\u5df4\u7624\u4e2d\uff0c\u764c\u57fa\u56e0MYC(\u539f\u67d3\u8272\u4f538\u4e0a\u7684c-myc)\u548cBCL2(\u539f\u67d3\u8272\u4f5318\u4e0a\u7684bcl-2)\u901a\u5e38\u8f6c\u4f4d\u5230\u67d3\u8272\u4f5314\u4e0a\u7684\u514d\u75ab\u7403\u86cb\u767d\u91cd\u94fe\u57fa\u56e0\uff0c\u6d3b\u5316\u7684MYC\u53ef\u4ee5\u523a\u6fc0\u6dcb\u5df4\u7ec6\u80de\u589e\u6b96\u3002\u5728\u6b63\u5e38\u6dcb\u5df4\u7ec6\u80de\u4e2d\uff0c\u589e\u6b96\u603b\u662f\u7531\u51cb\u4ea1\u6765\u5e73\u8861\uff0c\u800c\u6d3b\u5316\u7684Bcl-2\u86cb\u767d\u53ef\u963b\u6b62\u7ec6\u80de\u51cb\u4ea1\uff0c\u4ece\u800c\u4f7f\u6dcb\u5df4\u7ec6\u80de\u65e0\u9650\u5236\u589e\u6b96\u3002
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\u8868\u89c2\u9057\u4f20\u5b66\u6539\u53d8\u4e5f\u4f1a\u5728\u6076\u6027\u80bf\u7624\u7ec6\u80de\u4e2d\u53d1\u751f\uff0c\u4f8b\u5982\uff0c\u80bf\u7624\u6291\u5236\u57fa\u56e0\u7684\u6c38\u4e45\u7532\u57fa\u5316\u4f1a\u5bfc\u81f4\u8be5\u57fa\u56e0\u5bb6\u65cf\u7684\u8f6c\u5f55\u51cf\u5c11\u3002<\/p>\n

\u66b4\u9732\u4e8e\u8f90\u5c04\u540e\u66f4\u5bb9\u6613\u53d1\u751f\u764c\u57fa\u56e0\u6613\u4f4d\uff0c\u5982\u5e7f\u5c9b\u539f\u5b50\u5f39\u7206\u70b8\u7684\u5e78\u5b58\u8005\u4e2d\u9aa8\u9ad3\u7624\u5f88\u5e38\u89c1\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u75c5\u539f\u4f53<\/strong>
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\u75b1\u75b9\u75c5\u6bd2\u5bb6\u65cf\u548c\u9006\u8f6c\u5f55\u75c5\u6bd2\u611f\u67d3\u7ec6\u80de\u540e\u5e76\u6ca1\u6709\u6740\u6b7b\u7ec6\u80de\uff0c\u800c\u662f\u4fc3\u8fdb\u4e86\u7ec6\u80de\u7684\u4e0d\u53ef\u63a7\u751f\u957f\uff0c\u8fd9\u6837\u6709\u5229\u4e8e\u75c5\u6bd2\u81ea\u8eab\u7684\u751f\u5b58\u3002<\/p>\n

EB\u75c5\u6bd2(EBV)\u53ef\u5f15\u8d77\u4f20\u67d3\u6027\u5355\u6838\u7ec6\u80de\u589e\u591a\u75c7(\u7b2c15\u7ae0<\/span>)\u3001\u6dcb\u5df4\u7624\u548c\u9f3b\u54bd\u764c\u3002\u4e0e\u8bb8\u591a\u5176\u4ed6\u75c5\u6bd2\u4e0d\u540c\uff0cEBV\u7684\u611f\u67d3\u673a\u5236\u5e76\u4e0d\u662f\u901a\u8fc7\u589e\u52a0\u75c5\u6bd2\u7684\u4ea7\u751f\u548c\u7ec6\u80de\u7684\u7834\u574f(\u89c1Box 15.3<\/span>)\u3002\u76f8\u53cd\uff0cEBV\u901a\u8fc7\u4ea7\u751f\u4fc3\u8fdbB\u7ec6\u80de\u589e\u6b96\u548c\u6291\u5236\u51cb\u4ea1\u7684\u86cb\u767d\u8d28\u800c\u4f7f\u7ec6\u80de\u6c38\u751f\u3002EBV\u86cb\u767d\u8d28\u8fd8\u901a\u8fc7\u963b\u65ad\u6297\u539f\u63d0\u5448\u6765\u5e2e\u52a9\u611f\u67d3\u7ec6\u80de\u9003\u907f\u514d\u75ab\u53cd\u5e94\u3002<\/p>\n

EBV\u53ef\u5bfc\u81f4\u4e0d\u540c\u7c7b\u578b\u7684\u6dcb\u5df4\u7624(\u5305\u62ec\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u548c\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624)\u3002\u5728\u759f\u75be\u6d41\u884c\u7684\u5730\u533a\uff0c\u6bcf1000\u540d\u513f\u7ae5\u4e2d\u5c31\u67091\u4f8b\u53d1\u751f\u4f2f\u57fa\u7279\u6dcb\u5df4\u7624\uff0c\u8fd9\u662f\u759f\u75be\u548cEBV\u5bf9B\u7ec6\u80de\u591a\u514b\u9686\u6fc0\u6d3b\u7684\u7ed3\u679c\u3002\u4e25\u91cd\u7684\u591a\u514b\u9686B\u7ec6\u80de\u589e\u6b96\u4f1a\u589e\u52a0MYC\u7684\u6613\u4f4d\u98ce\u9669\uff0c\u4ece\u800c\u5bfc\u81f4\u6076\u6027\u80bf\u7624\u60a3\u8005\u7684\u589e\u591a\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u514d\u75ab\u7f3a\u9677\u60a3\u8005\u4e2d\uff0c\u9488\u5bf9\u53d7EBV\u611f\u67d3\u7684B\u7ec6\u80de\u7684\u6b63\u5e38\u514d\u75ab\u53cd\u5e94\u4e27\u5931\uff0c\u4f7f\u5f97EBV\u4fc3\u8fdbB\u7ec6\u80de\u7684\u751f\u957f\u3002B\u7ec6\u80de\u589e\u6b96\u6700\u521d\u662f\u591a\u514b\u9686\u7684\uff0c\u8868\u73b0\u4e3a\u4e00\u79cd\u4f34\u6709\u6dcb\u5df4\u7ed3\u75c5\u53d8\u7684\u957f\u671f\u5355\u6838\u7ec6\u80de\u589e\u591a\u7684\u75be\u75c5\uff0c\u968f\u540e\u53d1\u751f\u6d89\u53caMYC\u7684\u6613\u4f4d\uff0c\u5e76\u4fc3\u8fdb\u6076\u6027\u5355\u514b\u9686\u7fa4\u4f53\u7684\u751f\u957f\u3002\u82e5\u611f\u67d3\u53e6\u4e00\u79cd\u75b1\u75b9\u75c5\u6bd2\u2014\u2014\u4eba\u7c7b\u75b1\u75b9\u75c5\u6bd28\u578b(HHV8)\uff0c\u53ef\u5bfc\u81f4\u514d\u75ab\u7f3a\u9677\u60a3\u8005\u7684\u5361\u6ce2\u897f\u8089\u7624\u3002<\/p>\n

\u5e7d\u95e8\u87ba\u6746\u83cc\u662f\u53e6\u4e00\u79cd\u53ef\u5bfc\u81f4\u6dcb\u5df4\u7624\u53d1\u5c55\u7684\u751f\u7269\u3002\u5e7d\u95e8\u87ba\u6746\u83cc\u662f\u4e00\u79cd\u5f15\u53d1\u80c3\u90e8\u6162\u6027\u708e\u75c7\u7684\u7ec6\u83cc\uff0c \u8fd9\u901a\u5e38\u4f1a\u5bfc\u81f4\u80c3\u6e83\u75a1\u3002\u66f4\u7f55\u89c1\u7684\u662f\uff0c\u5e7d\u95e8\u87ba\u6746\u83cc\u5f15\u8d77\u7684\u708e\u75c7\u4f1a\u5bfc\u81f4\u7c98\u819c\u76f8\u5173\u6dcb\u5df4\u7ec4\u7ec7 (MALT) \u4e2d\u51fa\u73b0\u6dcb\u5df4\u7624\uff0c\u5bf9\u5e7d\u95e8\u87ba\u6746\u83cc\u7684\u6cbb\u7597\u53ef\u4f7f\u6dcb\u5df4\u7624\u75c5\u60c5\u7f13\u89e3\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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T\u7ec6\u80de\u6076\u6027\u80bf\u7624\u8f83\u4e3a\u7f55\u89c1\uff0c\u901a\u5e38\u662f\u7531\u4eba\u7c7bT\u6dcb\u5df4\u7ec6\u80de\u8425\u517b\u75c5\u6bd21(HTLV1)\u5f15\u8d77\u7684\u3002\u8fd9\u79cd\u9006\u8f6c\u5f55\u75c5\u6bd2\u7f16\u7801Tax\u86cb\u767d\uff0c\u5176\u4f5c\u7528\u7c7b\u4f3c\u4e8e\u767d\u7ec6\u80de\u4ecb\u7d202(IL-2\uff1bT\u7ec6\u80de\u751f\u957f\u56e0\u5b50)\u3002HTLV1\u5728\u53d1\u8fbe\u56fd\u5bb6\u5f88\u5c11\u89c1\u3002<\/p>\n

\u764c\u75c7\u901a\u5e38\u662f\u81f3\u5c11\u4e24\u4e2a\u5f71\u54cd\u57fa\u56e0\u8868\u8fbe\u7684\u56e0\u7d20\u5171\u540c\u4f5c\u7528\u7684\u7ed3\u679c\uff0cFig.35.2\u5c06\u8be6\u7ec6\u4ecb\u7ecd\u8fd9\u4e00\u8fc7\u7a0b<\/span><\/span>\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 35.2 <\/span>\u5728\u80bf\u7624\u53d1\u751f\u8fc7\u7a0b\u4e2d\u901a\u5e38\u5305\u542b\u4e00\u7cfb\u5217\u56e0\u7d20\u7684\u5e72\u9884\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6076\u6027\u6dcb\u5df4\u80bf\u7624\u7684\u8bca\u65ad<\/span><\/strong><\/p>\n<\/section>\n

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\u5728\u67d0\u4e9b\u7c7b\u578b\u7684\u6dcb\u5df4\u7cfb\u7edf\u6076\u6027\u80bf\u7624\u4e2d\uff0c\u901a\u8fc7\u5b83\u4eec\u7684\u5916\u89c2\u53ef\u4ee5\u8bc6\u522b\u5f02\u5e38\u7ec6\u80de\u3002\u4f8b\u5982\uff0c\u5728\u6025\u6027\u767d\u8840\u75c5\u4e2d\uff0c\u53ef\u89c2\u5bdf\u5230\u8840\u6db2\u548c\u9aa8\u9ad3\u4e2d\u5b58\u5728\u5927\u91cf\u4e0d\u6210\u719f\u7684\u7ec6\u80de\u3002\u6d41\u5f0f\u7ec6\u80de\u672f\u53ef\u4ee5\u7528\u6765\u533a\u5206\u7531\u4e2d\u6027\u7c92\u7ec6\u80de\u524d\u4f53\u5f15\u8d77\u7684\u6025\u6027\u9ad3\u7cfb\u767d\u8840\u75c5(AML)\u548c\u5b8c\u5168\u7531\u672a\u6210\u719f\u7684B\u7ec6\u80de\u524d\u4f53\u6240\u5f15\u8d77\u7684ALL\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u5728\u5176\u4ed6\u60c5\u51b5\u4e0b\uff0c\u6076\u6027\u80bf\u7624\u7ec6\u80de\u770b\u8d77\u6765\u4e0e\u6b63\u5e38\u7ec6\u80de\u975e\u5e38\u76f8\u4f3c\u3002\u4f8b\u5982\uff0c\u5728\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5 (CLL) \u4e2d\uff0c\u5f02\u5e38\u7ec6\u80de\u770b\u8d77\u6765\u4e0e\u6b63\u5e38\u7684\u6210\u719f\u6dcb\u5df4\u7ec6\u80de\u975e\u5e38\u76f8\u4f3c\u3002\u5982Box 35.1<\/span>\u6240\u8ff0\uff0c\u6d41\u5f0f\u7ec6\u80de\u672f\u53ef\u4ee5\u663e\u793a\u767d\u8840\u75c5\u7ec6\u80de\u8868\u9762\u662f\u5426\u5b58\u5728\u5f02\u5e38\u5206\u5b50\u3002<\/p>\n

\u6d46\u7ec6\u80de\u6076\u6027\u80bf\u7624\uff08\u9aa8\u9ad3\u7624\uff09\u662f\u4e00\u4e2a\u7279\u6b8a\u7684\u4f8b\u5b50\u3002Box35.2<\/span>\u4ecb\u7ecd\u4e86\u8fd9\u4e9b\u7ec6\u80de\u5206\u6ccc\u7684\u514d\u75ab\u7403\u86cb\u767d\u662f\u5982\u4f55\u4f5c\u4e3a\u6076\u6027\u80bf\u7624\u7684\u6807\u8bb0\u7269\u7684\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n


<\/p>\n<\/section>\n<\/section>\n

\n
\n

\u80bf\u7624\u514d\u75ab<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u524d\u9762\u5df2\u7ecf\u4ecb\u7ecd\u4e86\u9002\u5e94\u6027\u514d\u75ab\u7cfb\u7edf\u7684\u514d\u75ab\u7ec6\u80de\u5982\u4f55\u53d1\u5c55\u4e3a\u80bf\u7624\u3002\u9664\u6b64\u4e4b\u5916\uff0c\u514d\u75ab\u7cfb\u7edf\u7684\u7ec4\u6210\u90e8\u5206\u4e5f\u53ef\u4ee5\u8bc6\u522b\u5e76\u4e14\u6740\u6b7b\u51fa\u73b0\u5728\u5176\u4ed6\u7ec4\u7ec7\u4e2d\u7684\u6076\u6027\u80bf\u7624\u3002\u8fd9\u5bf9\u4e8e\u673a\u4f53\u975e\u5e38\u91cd\u8981\uff0c\u514d\u75ab\u7597\u6cd5\u53ef\u4ee5\u7ed9\u5927\u591a\u6570\u7c7b\u578b\u7684\u764c\u75c7\u60a3\u8005\u5e26\u6765\u5e0c\u671b\uff0c\u91cd\u70b9\u5728\u4e8e\u6076\u6027\u80bf\u7624\u7ec6\u80de\u662f\u5982\u4f55\u6210\u4e3a\u6297\u539f\uff0c\u6362\u53e5\u8bdd\u8bf4\uff0c\u5b83\u4eec\u662f\u5982\u4f55\u8868\u8fbe\u80bf\u7624\u6297\u539f\u7684\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u80bf\u7624\u6297\u539f<\/strong><\/p>\n<\/section>\n

\n
\n
\n

\u80bf\u7624\u6297\u539f\u662f\u80bf\u7624\u7ec6\u80de\u4ea7\u751f\u7684\u53ef\u88ab\u514d\u75ab\u7cfb\u7edf\u8bc6\u522b\u7684\u5206\u5b50\u3002\u6709\u8bb8\u591a\u4e0d\u540c\u7c7b\u578b\u7684\u80bf\u7624\u6297\u539f\uff1a<\/p>\n

\u53d1\u80b2\u86cb\u767d\uff1a<\/strong>\u8fd9\u4e9b\u86cb\u767d\u901a\u5e38\u53ea\u5728\u53d1\u80b2\u8fc7\u7a0b\u4e2d\u77ed\u6682\u8868\u8fbe\uff0c\u4f46\u53ef\u80fd\u4f1a\u88ab\u80bf\u7624\u7ec6\u80de\u91cd\u65b0\u8868\u8fbe\u3002\u4f8b\u5982\uff0c\u764c\u80da\u6297\u539f(CEA)\u901a\u5e38\u662f\u5728\u80ce\u513f\u65f6\u671f\u7684\u8bb8\u591a\u7ec4\u7ec7\u4e2d\u8868\u8fbe\uff0c\u800c\u5728\u80c3\u80a0\u9053\u80bf\u7624\u4e2d\uff0cCEA\u4e5f\u4f1a\u5f02\u5e38\u8868\u8fbe\u3002<\/p>\n

\u8c31\u7cfb\u7279\u5f02\u6027\u86cb\u767d\uff1a<\/strong>\u8fd9\u4e9b\u86cb\u767d\u5728\u764c\u7ec6\u80de\u548c\u5b83\u4eec\u8d77\u6e90\u7684\u6b63\u5e38\u7ec4\u7ec7\u4e2d\u8868\u8fbe\u3002\u4f8b\u5982\uff0c\u9ed1\u8272\u7d20\u7624\u662f\u4e00\u79cd\u9ed1\u8272\u7d20\u7ec6\u80de\u76ae\u80a4\u764c\u3002\u6b63\u5e38\u7684\u9ed1\u8272\u7d20\u7ec6\u80de\u548c\u9ed1\u8272\u7d20\u7624\u7ec6\u80de\u5747\u8868\u8fbe\u916a\u6c28\u9178\u9176\uff0c\u800c\u5728\u5176\u4ed6\u6b63\u5e38\u6216\u5f02\u5e38\u7ec6\u80de\u4e2d\u5747\u4e0d\u8868\u8fbe\u3002<\/p>\n

\u75c5\u6bd2\u86cb\u767d\uff1a<\/strong>\u4f8b\u5982\uff0cEBV\u548c\u4eba\u7c7b\u4e73\u5934\u7624\u75c5\u6bd2(HPV\uff0c\u5728\u5bab\u9888\u764c\u4e2d)\u4f1a\u4ea7\u751f\u7279\u5b9a\u7684\u86cb\u767d\u8d28\u3002<\/p>\n

\u901a\u8fc7\u6613\u4f4d\u4ea7\u751f\u7684\u86cb\u767d\u8d28\uff1a<\/strong>\u4f8b\u5982\uff0cBcr-Abl\u878d\u5408\u86cb\u767d\u662fBCR\/ABL1\u6613\u4f4d\u7684\u4ea7\u7269\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u53d1\u80b2\u86cb\u767d\u548c\u8c31\u7cfb\u7279\u5f02\u6027\u86cb\u767d\u514d\u75ab\u539f\u6027\u5dee\uff0c\u5b83\u4eec\u5728\u6b63\u5e38\u7ec4\u7ec7\u4e2d\u4e5f<\/span>\u4f1a\u8868\u8fbe\u3002\u5728T\u7ec6\u80de\u53d1\u80b2\u8fc7\u7a0b\u4e2d\uff0c\u53ef\u4ee5\u8bc6\u522b\u8fd9\u4e9b\u86cb\u767d\u7684T\u7ec6\u80de\u4f1a\u88ab\u6e05\u9664\u6389\uff0c\u4ece\u800c\u8bf1\u5bfc\u514d\u75ab\u8010\u53d7\u3002\u56e0\u6b64\uff0c\u9632\u6b62\u81ea\u8eab\u514d\u75ab\u7684\u540c\u65f6\u4e5f\u635f\u5bb3\u4e86\u5bf9\u80bf\u7624\u7684\u8bc6\u522b\u3002\u4f8b\u5982\uff0c\u7ed3\u80a0\u764c\u4e2d\u5b58\u5728\u7684CEA\u4e0d\u4f1a\u5f15\u8d77\u5f3a\u70c8\u7684\u514d\u75ab\u53cd\u5e94\u3002\u6240\u4ee5\uff0c\u9488\u5bf9CEA\u7684\u6d4b\u8bd5\u6709\u65f6\u4e5f\u88ab\u7528\u6765\u7b5b\u67e5\u8fd9\u79cd\u7c7b\u578b\u7684\u764c\u75c7\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u75c5\u6bd2\u86cb\u767d\u548c\u878d\u5408\u86cb\u767d\u5f80\u5f80\u66f4\u5177\u514d\u75ab\u539f\u6027\uff0c\u56e0\u4e3a\u5b83\u4eec\u539f\u672c\u5e76\u4e0d\u5b58\u5728\u4e8e\u6b63\u5e38\u4eba\u4f53\u5185<\/span>\u3002<\/span>\u9488\u5bf9\u5b83\u4eec\u7684\u836f\u7269\u5728\u8bca\u65ad\u3001\u9884\u9632\u548c\u6cbb\u7597\u764c\u75c7\u65b9\u9762\u53ef\u80fd\u7684\u4e34\u5e8a\u4f5c\u7528\u90fd\u5df2\u8fdb\u884c\u4e86\u7814\u7a76\u3002<\/p>\n

\u5230\u76ee\u524d\u4e3a\u6b62\uff0c\u63a5\u79cd\u75ab\u82d7\u5df2\u7ecf\u53ef\u7528\u4e8e\u9884\u9632\u4e24\u79cd\u764c\u75c7\u3002<\/p>\n

\u4e59\u578b\u809d\u708e\u75c5\u6bd2(HBV)\u53ef\u5bfc\u81f4\u809d\u764c\uff0c\u5728\u4e16\u754c\u67d0\u4e9b\u5730\u533a\uff0c\u809d\u764c\u5df2\u6210\u4e3a\u5bfc\u81f4\u6b7b\u4ea1\u7684\u4e3b\u8981\u539f\u56e0\u3002\u53f0\u6e7e\u5df2\u8bc1\u5b9e\u4e59\u809d\u75ab\u82d7\u5bf9\u809d\u764c\u6709\u8fd190%\u7684\u9884\u9632\u6548\u679c\u3002<\/p>\n

\u6709\u4e9b\u83cc\u682a\u7684HPV(\u5f15\u8d77\u75a3\u7684\u75c5\u6bd2)\u4f1a\u5bfc\u81f4\u5bab\u9888\u764c\u3002HPV\u75ab\u82d7\u662f\u5728\u672c\u4e16\u7eaa\u5934\u5341\u5e74\u5f15\u8fdb\u7684\uff0c\u65e9\u671f\u6570\u636e\u663e\u793a\uff0c\u75ab\u82d7\u8bf1\u5bfc\u4ea7\u751f\u7684\u514d\u75ab\u53ef\u80fd\u4f7f\u5bab\u9888\u764c\u53d1\u751f\u7387\u964d\u4f4e\u7ea650%\uff0cHPV\u75ab\u82d7\u5728\u7f8e\u56fd\u6bcf\u5e74\u53ef\u4fdd\u62a4\u7ea65\u4e07\u4eba\u514d\u4e8e\u6b7b\u4ea1\u3002<\/p>\n

\u7ecf\u8fc750\u5e74\u7684\u7814\u7a76\uff0c\u9488\u5bf9\u73b0\u6709\u764c\u75c7\u7684\u514d\u75ab\u7597\u6cd5\u53d6\u5f97\u4e86\u4e00\u4e9b\u8fdb\u5c55\u3002\u4e86\u89e3\u80bf\u7624\u514d\u75ab\u548c\u80bf\u7624\u5982\u4f55\u9003\u907f\u514d\u75ab\u7cfb\u7edf\u7684\u8bc6\u522b\uff0c\u5bf9\u4e8e\u7406\u89e3\u5728\u5f00\u53d1\u764c\u75c7\u6709\u6548\u6cbb\u7597\u65b9\u6cd5\u65f6\u6240\u9762\u4e34\u7684\u95ee\u9898\u662f\u5fc5\u8981\u7684\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u80bf\u7624\u514d\u75ab\u7684\u8bc1\u636e<\/strong><\/p>\n<\/section>\n

\n
\n
\n

\u514d\u75ab\u6291\u5236\u4eba\u7fa4\u60a3\u764c\u75c7\u7684\u6982\u7387\u5f88\u9ad8<\/span>\uff0c\u4f8b\u5982\u4e73\u5934\u7624\u75c5\u6bd2\u5f15\u8d77\u7684\u5bab\u9888\u764c(\u514d\u75ab\u6291\u5236\u60a3\u8005\u7684\u53d1\u75c5\u7387\u662f\u666e\u901a\u4eba\u7684100\u500d)\u3002\u8fd9\u4e9b\u80bf\u7624\u5728\u514d\u75ab\u7f3a\u9677\u60a3\u8005\u4e2d\u7684\u9ad8\u60a3\u75c5\u7387\u8bc1\u660e\u6bd4\u8d77\u8bc6\u522b\u80bf\u7624\uff0c\u514d\u75ab\u7cfb\u7edf\u5728\u6e05\u9664\u75c5\u6bd2\u611f\u67d3\u65b9\u9762\u66f4\u6709\u6548\u5730\u53d1\u6325\u4e86\u4f5c\u7528\uff0c\u5373\u5bf9\u75c5\u6bd2\u7684\u514d\u75ab\u76d1\u6d4b\u6bd4\u5bf9\u764c\u75c7\u7684\u76d1\u6d4b\u66f4\u6709\u6548\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u7136\u800c\uff0c\u4e5f\u6709\u4e00\u4e9b\u8bc1\u636e\u8868\u660e\uff0c\u4eba\u7c7b\u514d\u75ab\u7cfb\u7edf\u8bd5\u56fe\u901a\u8fc7\u8bc6\u522b\u524d\u9762\u63d0\u5230\u7684\u4e00\u4e9b\u6297\u539f\u6765\u6740\u4f24\u5176\u4ed6\u7c7b\u578b\u7684\u80bf\u7624\u3002\u5927\u591a\u6570\u7814\u7a76\u90fd\u96c6\u4e2d\u5728\u80bf\u7624\u6297\u539f\u7279\u5f02\u6027\u7684T\u7ec6\u80de(\u5982\u80bf\u7624\u6d78\u6da6\u6027\u6dcb\u5df4\u7ec6\u80de\uff0cTILs)\u4e0a\uff0c\u5982\u916a\u6c28\u9178\u9176\u9ed1\u8272\u7d20\u7624\u3002TIL\u5229\u7528\u5176TCR\u8bc6\u522b\u4e3b\u8981\u7ec4\u7ec7\u76f8\u5bb9\u6027\u590d\u5408\u4f53(MHC)\u63d0\u5448\u7684\u6297\u539f\u3002<\/p>\n

\u514d\u75ab\u7cfb\u7edf\u5076\u5c14\u4f1a\u7834\u574f\u80bf\u7624\u7684\u8840\u6db2\u4f9b\u5e94\uff0c\u5e76\u901a\u8fc7\u80bf\u7624\u7ec6\u80de\u7f3a\u6c27\u7684\u65b9\u5f0f\uff0c\u5bfc\u81f4\u80bf\u7624\u574f\u6b7b\u3002\u65e9\u671f\u7684\u5b9e\u9a8c\u8868\u660e\uff0c\u5728\u9ad8\u5242\u91cf\u6ce8\u5c04\u80bf\u7624\u574f\u6b7b\u56e0\u5b50(TNF)\u5230\u8377\u7624\u5c0f\u9f20\u65f6\u53ef\u505a\u5230\uff0c\u4f46\u76ee\u524d\u8fd8\u4e0d\u6e05\u695a\u8fd9\u4e9b\u673a\u5236\u5728\u4eba\u7c7b\u80bf\u7624\u4e2d\u7684\u91cd\u8981\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u80bf\u7624\u5bf9\u514d\u75ab\u5e94\u7b54\u7684\u9003\u907f<\/strong><\/p>\n<\/section>\n

\n
\n
\n

\u4e0e\u611f\u67d3\u4e0d\u540c\uff0c\u80bf\u7624\u5f88\u5c11\u4ea7\u751f\u5371\u9669\u4fe1\u53f7\uff0c\u5e76\u4e14\u4e0d\u4f1a\u901a\u8fc7 Toll \u6837\u53d7\u4f53 (TLR) \u6216\u5176\u4ed6\u6a21\u5f0f\u8bc6\u522b\u5206\u5b50\u6fc0\u6d3b\u56fa\u6709\u514d\u75ab\u7cfb\u7edf\u3002\u8fd9\u610f\u5473\u7740\u5148\u5929\u514d\u75ab\u7cfb\u7edf\u901a\u5e38\u4e0d\u4f1a\u6740\u6b7b\u80bf\u7624\u7ec6\u80de\uff08\u9664NK\u7ec6\u80de\u5916\uff09\uff0c\u4e5f\u4e0d\u4f1a\u5bf9\u9002\u5e94\u6027\u514d\u75ab\u7cfb\u7edf\u53d1\u51fa\u8b66\u62a5\u3002\u8fd9\u53ef\u80fd\u5bfc\u81f4 T \u7ec6\u80de\u5bf9\u6297\u539f\u65e0\u53cd\u5e94\u3002<\/p>\n

\u4e00\u4e9b\u80bf\u7624\u901a\u8fc7\u51cf\u5c11MHC\u7684\u8868\u8fbe\u53ca\u5176\u5411T\u7ec6\u80de\u63d0\u5448\u6297\u539f\u7684\u80fd\u529b\u6765\u9003\u907f\u9002\u5e94\u6027\u514d\u75ab\u5e94\u7b54\u3002\u5728\u8fd9\u4e9b\u80bf\u7624\u4e2d\uff0cMHC\u57fa\u56e0\u7684\u7a81\u53d8\u5e76\u4e0d\u5c11\u89c1\u3002\u4f4e\u6c34\u5e73\u8868\u8fbeMHC\u7684\u7ec6\u80de\u662f\u81ea\u7136\u6740\u4f24(NK)\u7ec6\u80de\u6740\u4f24\u7684\u6781\u4f73\u9776\u70b9\uff0c\u5728\u8fd9\u79cd\u60c5\u51b5\u4e0b\uff0cNK\u7ec6\u80de\u53ef\u4ee5\u4f5c\u4e3a\u540e\u5907\u7cfb\u7edf\u3002<\/p>\n

\u6076\u6027\u80bf\u7624\u7ec6\u80de\u901a\u8fc7\u5404\u79cd\u673a\u5236\u6210\u529f\u5730\u9003\u907f\u514d\u75ab\u53cd\u5e94\uff0c\u5feb\u901f\u5206\u88c2\u7684\u6076\u6027\u7ec6\u80de\u53ef\u80fd\u4f1a\u53d1\u751f\u53d8\u5f02\uff0c\u5e76\u83b7\u5f97\u4e00\u79cd\u6216\u591a\u79cd\u9003\u9038\u673a\u5236\uff0c\u8fd9\u5c06\u4f7f\u8fd9\u79cd\u7ec6\u80de\u514b\u9686\u6bd4\u672a\u7a81\u53d8\u7684\u7ec6\u80de\u66f4\u5177\u4f18\u52bf\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n


<\/p>\n<\/section>\n<\/section>\n

\n
\n

\u514d\u75ab\u7597\u6cd5<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u514d\u75ab\u7597\u6cd5\u7684\u5c1d\u8bd5\u662f\u57fa\u4e8e\u514d\u75ab\u7cfb\u7edf\u53ef\u4ee5\u6839\u9664\u80bf\u7624\u7684\u60f3\u6cd5\u3002\u4eba\u4eec\u5df2\u7ecf\u8bd5\u9a8c\u4e86\u8bb8\u591a\u80bf\u7624\u514d\u75ab\u6cbb\u7597\u7684\u65b9\u6cd5\uff0c\u4f46\u5927\u591a\u6570\u90fd\u5931\u8d25\u4e86\u3002\u672c\u6587\u4ec5\u4ecb\u7ecd\u4e00\u4e9b\u5df2\u7ecf\u53d6\u5f97\u4e00\u5b9a\u6210\u529f\u7684\u514d\u75ab\u6cbb\u7597\u65b9\u6cd5\u3002<\/p>\n

\u514d\u75ab\u6cbb\u7597\u53ef\u5206\u4e3a\u88ab\u52a8\u514d\u75ab\u6cbb\u7597\uff0c\u5373\u7ed9\u4e88\u73b0\u6709\u7684\u514d\u75ab\u5236\u5242(\u901a\u5e38\u662f\u5355\u514b\u9686\u6297\u4f53)\uff1b\u6216\u4e3b\u52a8\u514d\u75ab\u6cbb\u7597\uff0c\u5373\u6fc0\u6d3b\u60a3\u8005\u81ea\u8eab\u7684\u514d\u75ab\u53cd\u5e94\u4ee5\u5bf9\u80bf\u7624\u4f5c\u51fa\u53cd\u5e94\u3002\u4e3b\u52a8\u514d\u75ab\u662f\u66f4\u597d\u7684\u65b9\u6cd5\uff0c\u56e0\u4e3a\u5b83\u53ef\u4ee5\u9488\u5bf9\u60a3\u8005\u786e\u5207\u7684\u80bf\u7624\u6297\u539f\u7ec8\u751f\u4ea7\u751f\u53cd\u5e94\u3002\u88ab\u52a8\u514d\u75ab\u4ec5\u5728\u7ed9\u836f\u671f\u95f4\u7ef4\u6301\uff0c\u662f\u4e00\u79cd\u901a\u7528\u6cbb\u7597\u65b9\u6cd5\uff0c\u4f46\u4e0d\u662f\u5b8c\u5168\u5408\u9002\u7684\u6cbb\u7597\u65b9\u6cd5\u3002Table.35.2<\/span>\u5c55\u793a\u4e86\u4e00\u4e9b\u764c\u75c7\u514d\u75ab\u6cbb\u7597\u65b9\u6cd5\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
<\/section>\n<\/section>\n
\n
\n
\n


<\/p>\n<\/section>\n<\/section>\n

\n
\n

Table 35.2<\/span> \u80bf\u7624\u514d\u75ab\u6cbb\u7597\u65b9\u6cd5<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u88ab\u52a8\u80bf\u7624\u514d\u75ab\u6cbb\u7597<\/strong><\/p>\n<\/section>\n

\n
\n
\n

\u5355\u514b\u9686\u6297\u4f53(mAbs)\u53ef\u4ea7\u751f\u591a\u79cd\u6297\u80bf\u7624\u4f5c\u7528\uff0c\u5e76\u80fd\u6fc0\u6d3b\u514d\u75ab\u7cfb\u7edf\u7684\u6740\u4f24\u673a\u5236\u3002\u4f8b\u5982\uff0c\u5b83\u4eec\u53ef\u4ee5\u6fc0\u6d3b\u8865\u4f53(Fig.35.3<\/span>)\u3002\u4e00\u4e9b\u5355\u6297\u4e0e\u81ea\u7136\u6740\u4f24\u7ec6\u80de\u8868\u9762\u7684Fc\u53d7\u4f53\u7ed3\u5408\uff0c\u8bf1\u53d1\u6297\u4f53\u4f9d\u8d56\u6027\u7684\u7ec6\u80de\u6740\u4f24\u4f5c\u7528(\u7b2c22\u7ae0<\/span>)\u3002\u6216\u8005\u53ef\u4ee5\u5bf9mAB\u8fdb\u884c\u6539\u9020\uff0c\u4f7f\u5176\u5411\u80bf\u7624\u7ec6\u80de\u8f93\u9001\u653e\u5c04\u7ebf\u6216\u6bd2\u7d20\u3002<\/p>\n

\u4e00\u4e9b\u80bf\u7624\u6297\u539f\u4e0e\u53ef\u88ab\u5355\u514b\u9686\u6297\u4f53\u89e6\u53d1\u6216\u963b\u65ad\u7684\u4fe1\u53f7\u901a\u8def\u6709\u5173\u3002\u4f8b\u5982\uff0c\u5229\u59a5\u6614\u5355\u6297\u4e0eCD20\u7ed3\u5408,CD20\u662f\u4e00\u79cd\u5b58\u5728\u4e8eB\u7ec6\u80de\u4e0a\u7684\u4fe1\u53f7\u5206\u5b50\u3002\u5f53mAb\u4e0e\u8be5\u5206\u5b50\u7ed3\u5408\u65f6\uff0c\u5b83\u53ef\u4ee5\u89e6\u53d1\u6076\u6027B\u7ec6\u80de\u7684\u51cb\u4ea1\u3002<\/p>\n

Trastuzumab(\u8d6b\u8d5b\u6c40)\u662f\u4e00\u79cd\u9488\u5bf9HER2\u7684\u6297\u4f53\uff0cHER2\u662f\u4e00\u79cd\u8868\u76ae\u751f\u957f\u56e0\u5b50\u53d7\u4f53\uff0c\u5927\u7ea630%\u7684\u4e73\u817a\u764c\u7ec6\u80de\u4e0a\u5b58\u5728\u8fd9\u79cd\u53d7\u4f53\u3002Trastuzumab\u53ef\u963b\u6b62\u8be5\u53d7\u4f53\u5206\u5b50\u8f6c\u5bfc\u4fe1\u53f7\u5e76\u963b\u6b62\u80bf\u7624\u7ec6\u80de\u751f\u957f\u3002<\/p>\n

\u53e6\u4e00\u65b9\u9762\uff0c\u4e00\u4e9b\u764c\u75c7\u4f9d\u8d56\u8840\u7ba1\u5185\u76ae\u751f\u957f\u56e0\u5b50(VEGF)\u6765\u4fdd\u8bc1\u5145\u8db3\u7684\u8840\u6db2\u4f9b\u5e94\u3002\u8840\u7ba1\u5185\u76ae\u751f\u957f\u56e0\u5b50\u53ca\u5176\u53d7\u4f53\u53ef\u88ab\u5355\u6297(\u5982\u8d1d\u4f10\u5355\u6297)\u963b\u65ad\uff0c\u56e0\u6b64\u5728\u67d0\u4e9b\u7ed3\u80a0\u3001\u80ba\u548c\u4e73\u817a\u764c\u4e2d\u6709\u4e00\u5b9a\u7684\u5e94\u7528\u3002\u7b2c36\u7ae0<\/span>\u66f4\u8be6\u7ec6\u5730\u8ba8\u8bba\u4e86mAbs\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
<\/section>\n<\/section>\n
\n
\n
\n


<\/p>\n<\/section>\n<\/section>\n

\n
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Fig 35.3<\/span> \u5355\u514b\u9686\u6297\u4f53(mAb)\u53ef\u901a\u8fc7\u591a\u79cd\u65b9\u5f0f\u7834\u574f\u80bf\u7624\u7ec6\u80de\u3002NK\uff0c\u81ea\u7136\u6740\u4f24\u7ec6\u80de\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

\u4e3b\u52a8\u80bf\u7624\u514d\u75ab\u6cbb\u7597<\/strong><\/p>\n<\/section>\n

\n
\n
\n

\u4e3b\u52a8\u514d\u75ab\u6cbb\u7597\u5fc5\u987b\u514b\u670d\u8010\u53d7\u673a\u5236\uff0c\u624d\u80fd\u5bf9\u80bf\u7624\u6297\u539f\u4ea7\u751f\u53cd\u5e94(Fig.35.4<\/span>)\u3002\u5982\u679c\u80fd\u523a\u6fc0TLR\uff0c\u5c31\u4f1a\u6fc0\u6d3b\u5148\u5929\u514d\u75ab\u7cfb\u7edf\uff0c\u8fd9\u53ef\u80fd\u6709\u52a9\u4e8e\u514b\u670d\u8010\u53d7\u6027\u3002\u5728TLR\u523a\u6fc0\u4e0b\uff0c\u591a\u79cd\u7ec6\u80de\u5206\u6ccc\u4fc3\u708e\u7ec6\u80de\u56e0\u5b50\u3002<\/p>\n

\u6cbb\u7597\u8180\u80f1\u764c\u65f6\u53ef\u80fd\u4f1a\u901a\u8fc7\u5185\u7aa5\u955c\u6ce8\u5c04\u5361\u4ecb\u82d7\u6d3b\u75ab\u82d7(BCG\uff0c\u7b2c25\u7ae0<\/span>)\u3002\u5361\u4ecb\u82d7\u53ef\u4ee5\u5728\u6ce8\u5c04\u90e8\u4f4d\u590d\u5236\uff0c\u4f46\u4e0d\u4f1a\u5b58\u6d3b\u5f88\u957f\u65f6\u95f4\uff0c\u671f\u95f4\u4f1a\u6fc0\u6d3bTLR2\u548cTLR4\u5e76\u89e6\u53d1\u9002\u5e94\u6027\u514d\u75ab\u53cd\u5e94\u3002\u54aa\u55b9\u83ab\u7279\u662fTLR7\u7684\u5408\u6210\u914d\u4f53\uff0c\u4e5f\u95f4\u63a5\u6fc0\u6d3b\u9002\u5e94\u6027\u514d\u75ab\u53cd\u5e94\uff08Box 21.2<\/span>\uff09\u3002\u54aa\u55b9\u83ab\u7279\u5df2\u7ecf\u5e94\u7528\u4e8e\u6cbb\u7597\u4e00\u4e9b\u76ae\u80a4\u764c\uff0c\u4f8b\u5982\u57fa\u5e95\u7ec6\u80de\u764c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
<\/section>\n<\/section>\n


<\/p>\n

\n
\n
\n


<\/p>\n<\/section>\n<\/section>\n

\n
\n

Fig 35.4<\/span> A. \u6d78\u6da6\u7684T\u7ec6\u80de\u53ef\u4ee5\u8bc6\u522b\u80bf\u7624\u6297\u539f\u3002B. \u7ecf\u8fc7\u6cbb\u7597\u540e\u6d78\u6da6\u7684T\u7ec6\u80de\u6570\u91cf\u589e\u52a0\uff0c\u6709\u4fc3\u708e\u7ec6\u80de\u56e0\u5b50\u5b58\u5728\uff0cCTLA4\u88abCD28\u53d6\u4ee3\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u7b2c16\u7ae0<\/span>\u4ecb\u7ecd\u4e86\u5728\u5bf9\u6297\u539f\u4ea7\u751f\u514d\u75ab\u5e94\u7b54\u671f\u95f4\u5f62\u6210\u7684\u5171\u523a\u6fc0\u914d\u4f53\u5bf9–CD28(\u5728T\u7ec6\u80de\u4e0a)\u548cCD80(\u5728\u6297\u539f\u63d0\u5448\u7ec6\u80de\u4e0a)\u3002\u8fd9\u5bf9\u53d7\u4f53\u548c\u914d\u4f53\u63d0\u4f9b\u6d3b\u5316\u7684\u7b2c\u4e8c\u4fe1\u53f7\uff0c\u80fd\u591f\u786e\u4fddT\u7ec6\u80de\u5f7b\u5e95\u6fc0\u6d3b\u3002<\/p>\n

\u5728\u67d0\u4e9b\u60c5\u51b5\u4e0b\uff0c\u4f8b\u5982\u5bf9\u67d0\u4e9b\u764c\u7ec6\u80de\u7684\u53cd\u5e94\uff0cT\u7ec6\u80de\u4e0a\u7684CD28\u88abCTLA4\u53d6\u4ee3\uff0cCTLA4\u4e0d\u80fd\u63d0\u4f9b\u5171\u523a\u6fc0\u4fe1\u53f7\uff0c\u5bfc\u81f4\u673a\u4f53\u5bf9\u764c\u7ec6\u80de\u4ea7\u751f\u8010\u53d7\u3002\u5355\u514b\u9686\u6297\u4f53\uff0c\u5982\u4f0a\u666e\u5229\u5355\u6297\u53ef\u4ee5\u7ed3\u5408CTLA4\uff0c\u5e76\u53ef\u4ee5\u63d0\u4f9b\u5171\u523a\u6fc0\u4fe1\u53f7\u3002\u8fd9\u5df2\u5728\u4e00\u4e9b\u665a\u671f\u80bf\u7624\uff0c\u5982\u9ed1\u8272\u7d20\u7624\u4e2d\u88ab\u8bc1\u660e\u662f\u6210\u529f\u7684\u3002<\/p>\n

\u53e6\u4e00\u79cd\u65b9\u6cd5\u662f\u901a\u8fc7\u80bf\u7624\u6297\u539f\u7684\u7279\u5f02\u6027\u53d7\u4f53\u6765\u589e\u52a0 T \u7ec6\u80de\u7684\u6570\u91cf\u5e76\u4fc3\u8fdb\u5176\u6fc0\u6d3b\u3002\u5fc5\u987b\u4f7f\u7528\u60a3\u8005\u81ea\u8eabT \u7ec6\u80de\uff0c\u56e0\u4e3a\u53ea\u6709\u8fd9\u4e9b\u7ec6\u80de\u8868\u8fbe\u80fd\u591f\u8bc6\u522b\u81ea\u8eab MHC \u7684 TCR\u3002\u4f8b\u5982\u4f7f\u7528\u7ec6\u80de\u56e0\u5b50\u5728\u4f53\u5916\u6fc0\u6d3b\u80bf\u7624\u6d78\u6da6\u6dcb\u5df4\u7ec6\u80de\u3002\u589e\u52a0\u8fd9\u4e9bTIL\u7684\u6570\u91cf\uff0c\u5e76\u91cd\u65b0\u6ce8\u5165\u60a3\u8005\u4f53\u5185\u3002\u8fd9\u79cd\u65b9\u6cd5\u4f9d\u8d56\u4e8e\u53ef\u7528\u7684\u81ea\u8eab\u7ec4\u7ec7\u7ec6\u80de\u5e76\u9700\u8981\u4ea7\u751f\u8db3\u591f\u6570\u91cf\u7684TIL\u3002<\/p>\n

\u6216\u8005\uff0c\u53ef\u4ee5\u4ece\u60a3\u8005\u7684\u8840\u6db2\u4e2d\u5206\u79bb\u51faT\u7ec6\u80de\uff0c\u5e76\u5bf9\u5176\u8fdb\u884c\u57fa\u56e0\u6539\u9020\u4ee5\u8868\u8fbe\u53ef\u4ee5\u8bc6\u522b\u80bf\u7624\u6297\u539f\u7684TCR\uff0c\u8fd9\u4e9b\u7ec6\u80de\u5728\u88ab\u7ec6\u80de\u56e0\u5b50\u6fc0\u6d3b\u540e\u53ef\u4ee5\u91cd\u65b0\u6ce8\u5165\u60a3\u8005\u4f53\u5185\u3002\u8fd9\u79cd\u65b9\u6cd5\u9700\u8981\u77e5\u9053\u60a3\u8005\u7684\u80bf\u7624\u6297\u539f\u7ed3\u6784\u3002<\/p>\n

\u8fd9\u4e9b\u65b9\u6cd5\u4e2d\u6709\u8bb8\u591a\u662f\u6709\u4e89\u8bae\u7684\u3002\u4f8b\u5982\uff0c\u57fa\u4e8e\u60a3\u8005T\u7ec6\u80de\u7684\u6cbb\u7597\u65e2\u6602\u8d35\u53c8\u8d39\u529b\uff0c\u800c\u4e14\u4e0d\u80fd\u4fdd\u8bc1\u6210\u529f\u3002\u201c\u73b0\u6210\u201d\u7684\u5355\u514b\u9686\u6297\u4f53\u53ef\u4ee5\u4fbf\u5b9c\u4e00\u4e9b\uff0c\u4f46\u53ea\u6709\u90e8\u5206\u6709\u6548\u3002\u4f8b\u5982\uff0c\u5728\u5e38\u89c4\u7ec6\u80de\u6bd2\u6027\u5316\u7597\u7684\u57fa\u7840\u4e0a\uff0c\u8d1d\u4f10\u5355\u6297\u53ef\u5c06\u8f6c\u79fb\u6027\u7ed3\u80a0\u764c\u7684\u4e2d\u4f4d\u751f\u5b58\u671f\u4ece\u7ea626\u4e2a\u6708\u63d0\u9ad8\u523030\u4e2a\u6708\u3002\u8fd9\u4e9b\u7597\u6cd5\u7684\u91cd\u8981\u6027\u5728\u4e8e\u8bc1\u5b9e\u764c\u75c7\u514d\u75ab\u7597\u6cd5\u786e\u5b9e\u662f\u6709\u6548\u7684\uff0c\u5bf9\u5b83\u4eec\u7684\u8fdb\u4e00\u6b65\u7684\u7814\u7a76\u4e5f\u662f\u5f88\u6709\u5fc5\u8981\u7684\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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BOX 35.1<\/span>\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5<\/span><\/p>\n<\/section>\n<\/section>\n

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\u7537\u6027\u60a3\u8005\uff0c\u5e26\u72b6\u75b1\u75b9\u611f\u67d3\uff0c\u8868\u73b0\u4e3a\u8f7b\u5ea6\u7ee7\u53d1\u6027\u514d\u75ab\u7f3a\u9677\u72b6\u6001\u3002\u68c0\u67e5\u540e\u53d1\u73b0\u5176\u60a3\u6709\u5168\u8eab\u6027\u6dcb\u5df4\u7ed3\u75c5\u3002\u8fd9\u4e9b\u4e34\u5e8a\u7279\u5f81\u4e0e\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5(CLL)\u6216\u6dcb\u5df4\u7624\u76f8\u4e00\u81f4\u3002<\/p>\n

\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u7ed3\u679c\uff1a\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570\u5347\u9ad8(5.6\u00d7106<\/sup>\/mL\uff1b\u6b63\u5e38\u8303\u56f4\u4e3a1.5\u81f33.0\u00d7106<\/sup>\/mL)\uff0c\u53ef\u89c1\u7684\u4e2d\u6027\u7c92\u7ec6\u80de\u7684\u6570\u91cf\u5e94\u8be5\u8d85\u8fc7\u6dcb\u5df4\u7ec6\u80de\u7684\u6570\u91cf\u3002\u5728Fig 35.5<\/span>\u4e2d\uff0c\u867d\u7136\u53ef\u4ee5\u770b\u52306\u4e2a\u6dcb\u5df4\u7ec6\u80de\uff0c\u4f46\u6ca1\u6709\u4e2d\u6027\u7c92\u7ec6\u80de\u3002\u6dcb\u5df4\u7ec6\u80de\u5f62\u6001\u6b63\u5e38\uff0c\u6ca1\u6709\u7b26\u5408\u767d\u8840\u75c5\u6216\u6dcb\u5df4\u7624\u7684\u7279\u5f81\u3002<\/p>\n

\u6d41\u5f0f\u7ec6\u80de\u4eea\u68c0\u6d4b\u5f02\u5e38\u7ec6\u80de\u8868\u9762\u7684\u5206\u5b50\u3002Fig 35.6<\/span>\u663e\u793a\u6dcb\u5df4\u7ec6\u80de\u662f\u8868\u8fbeCD5\u5206\u5b50\u7684\u5f02\u5e38B\u7ec6\u80de\u3002\u5e26\u72b6\u75b1\u75b9\u7ee7\u53d1\u4e8eB\u7ec6\u80deCLL\u7684\u514d\u75ab\u7f3a\u9677\u5f15\u8d77\u7684\u3002<\/span><\/p>\n<\/section>\n<\/section>\n

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Fig.35.5<\/span> \u8840\u6db2\u6837\u672c\u663e\u793a\u6dcb\u5df4\u7ec6\u80de\u660e\u663e\u589e\u591a\u3002<\/p>\n<\/section>\n

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Fig.35.6<\/span> A. \u5065\u5eb7\u4eba\u7684\u6d41\u5f0f\u7ec6\u80de\u7ed3\u679c\u3002\u5b58\u5728\u4e0d\u540c\u7684T\u7ec6\u80de\u548cB\u7ec6\u80de\u7fa4\u4f53\u3002B. \u6240\u6709\u7ec6\u80de\u5747\u8868\u8fbeCD5\u548cCD19\u3002\u8fd9\u662f\u4e00\u79cd\u5178\u578b\u7684\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5(CLL)\u7684\u5f02\u5e38\u7ec4\u5408\u3002(\u82f1\u56fd\u66fc\u5f7b\u65af\u7279\u66fc\u5f7b\u65af\u7279\u7687\u5bb6\u533b\u9662\u7ea6\u7ff0\u00b7\u4f11\u4f0a\u7279\u63d0\u4f9b)<\/span>
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BOX 35.2<\/span> \u9aa8\u9ad3\u7624<\/p>\n<\/section>\n<\/section>\n

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\u5973\u6027\u60a3\u8005\u51fa\u73b0\u75b2\u52b3\u3001\u9aa8\u75db\uff0c\u7535\u6cf3\u663e\u793a\u5176\u8840\u6e05\u4e2d\u6709\u4e00\u6761\u4ee3\u8868\u8840\u6e05\u4e2d\u7684\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d(Ig)Gk\u5e26\u3002(Fig.35.7<\/span>)\uff0c\u6b64\u5916\uff0c\u5c3f\u6db2\u4e2d\u5b58\u5728\u6e38\u79bb\u7684\u03ba\u8f7b\u94fe\uff0c\u79f0\u4e3a\u672c\u65af-\u743c\u65af\u86cb\u767d\u3002<\/p>\n

X\u5149\u7247\u663e\u793a\u5176\u60a3\u6709\u591a\u53d1\u6027\u6eb6\u9aa8\u6027\u75c5\u53d8(Fig.35.8<\/span>)\u3002\u6b64\u5916\uff0c\u9aa8\u9ad3\u7a7f\u523a\u8bc1\u5b9e\u6d46\u7ec6\u80de\u6570\u91cf\u8fc7\u591a(Fig.35.9<\/span>)\u3002\u6709\u6eb6\u9aa8\u6027\u75c5\u53d8\u7684\u8840\u6e05\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\u548c\u5c3f\u5355\u514b\u9686\u8f7b\u94fe\u7684\u5b58\u5728\u8bc1\u5b9e\u4e86\u9aa8\u9ad3\u7624\u7684\u8bca\u65ad\u3002<\/p>\n

\u53e6\u5916\uff0c\u4e00\u4e9b\u611f\u67d3\u53ef\u4ea7\u751f\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\uff0c\u5728\u5065\u5eb7\u7684\u8001\u5e74\u4eba\u7fa4\u53ef\u51fa\u73b0\uff0c\u8fd9\u5c31\u662f\u610f\u4e49\u4e0d\u660e\u7684\u5355\u514b\u9686\u4e19\u79cd\u7403\u86cb\u767d\u75c5(MGUS)\u3002\u7136\u800c\uff0c\u5728\u9aa8\u9ad3\u7624\u4e2d\uff0c\u6076\u6027\u6d46\u7ec6\u80de\u4e5f\u4f1a\u4ea7\u751f\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\uff0c\u5728\u8fd9\u79cd\u60c5\u51b5\u4e0b\uff0c\u9aa8\u9ad3\u6d46\u7ec6\u80de\u7684\u6570\u91cf\u4f1a\u663e\u8457\u589e\u52a0\u3002\u9aa8\u7834\u574f(\u6eb6\u9aa8\u6027\u75c5\u53d8)\u89c1\u4e8e\u4e00\u4e9b\u9aa8\u9ad3\u7624\u60a3\u8005\uff0c\u4f46\u5728MGUS\u4e2d\u4ece\u672a\u89c1\u8fc7\uff0c\u8fd9\u6709\u52a9\u4e8e\u533a\u5206\u8fd9\u4e24\u79cd\u60c5\u51b5\u3002<\/p>\n

\u4e0a\u8ff0\u60a3\u8005\u5f00\u59cb\u63a5\u53d7\u7ec6\u80de\u6bd2\u6027\u5316\u7597\uff0c\u6700\u521d\u53cd\u5e94\u826f\u597d\uff0c\u4f46\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u5979\u611f\u67d3\u4e86\u80ba\u708e\u55dc\u8840\u6746\u83cc\uff0c\u8fd9\u662f\u5979\u6297\u4f53\u7f3a\u4e4f\u7684\u7ed3\u679c\uff0c\u6700\u7ec8\u5bfc\u81f4\u6b7b\u4ea1\u3002<\/p>\n<\/section>\n<\/section>\n

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Fig 35.7<\/span> \u5de6\u8fb9\u7684\u8840\u6e05\u7535\u6cf3\u6761\u6765\u81ea\u5065\u5eb7\u5bf9\u7167\u3002\u53f3\u8fb9\u7684\u6761\u5e26\u663e\u793a\u4e86\u03b3\u533a\u57df\u7684\u4e00\u6761\u5e26\uff0c\u5b83\u53cd\u6620\u4e86\u4e00\u79cd\u5355\u514b\u9686\u514d\u75ab\u7403\u86cb\u767d\u3002\u5c06\u6b64\u56fe\u50cf\u4e0e<\/span>Fig.4.4<\/span>\u8fdb\u884c\u6bd4\u8f83\u3002(\u7531\u82f1\u56fd\u66fc\u5f7b\u65af\u7279\u66fc\u5f7b\u65af\u7279\u7687\u5bb6\u533b\u9662\u7684Karen Sneade\u63d0\u4f9b\u3002<\/span><\/p>\n<\/section>\n<\/section>\n

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Fig 35.8<\/span> \u9885\u9aa8\u68c0\u6d4b\u663e\u793a\u591a\u5904\u6eb6\u8840\u6027\u75c5\u53d8\u3002\u9ad8\u9499\u8840\u75c7\u662f\u9aa8\u5438\u6536\u589e\u52a0\u7684\u7ed3\u679c\uff0c\u5e76\u5bfc\u81f4\u80be\u529f\u80fd\u8870\u7aed\u3002(\u4f26\u6566\u5723\u5df4\u585e\u6d1b\u7f2a\u533b\u9662\u63d0\u4f9b)<\/span><\/p>\n<\/section>\n<\/section>\n

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Fig 35.9<\/span> \u8fd9\u5f20\u56fe\u663e\u793a\u4e86\u75c5\u4eba\u7684\u9aa8\u9ad3\u7a7f\u523a\u7ec6\u80de\u6d82\u7247\u3002\u8fd9\u4e00\u533a\u57df\u7684\u6240\u6709\u7ec6\u80de\u90fd\u662f\u6d46\u7ec6\u80de\uff0c\u5b83\u4eec\u5206\u6ccc\u5982Fig 35.7<\/span>\u6240\u793a\u7684\u5355\u514b\u9686\u6027\u514d\u75ab\u7403\u86cb\u767d\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\u672c\u6587\u7531Oncolab\u5b9e\u9a8c\u5ba4\u5fae\u4fe1\u516c\u4f17\u53f7\u7ffb\u8bd1\u6574\u7406\u81eaImmunology for Medical Students\uff0c\u4ec5\u7528\u4e8e\u5b66\u4e60\u4ea4\u6d41\u4f7f\u7528\uff0c\u5982\u9700\u8d2d\u4e70\u539f\u7248\u4e66\u7c4d\u53ef\u70b9\u51fb\u9605\u8bfb\u539f\u6587\u8d2d\u4e70\u3002<\/span><\/p>\n


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\u2014 THE  END \u2014<\/span><\/p>\n


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\u6765\u6e90 | Immunology for Medical Students<\/span><\/section>\n
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\u7f16\u8f91\u6392\u7248 | \u6f58\u541b\u541b<\/span><\/span><\/section>\n
\u521d\u5ba1 | \u848b\u4fca\u535a \u5b8b\u4e50<\/span><\/span><\/section>\n
\u7ec8\u5ba1 | \u8096\u5efa\u52c7 \u738b\u5764<\/span><\/section>\n
\uff08\u8f6c\u8f7d\u8bf7\u4fdd\u7559\u6b64\u90e8\u5206\u5185\u5bb9\uff09<\/span><\/section>\n

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\u2589  OncoLab\u5b9e\u9a8c\u5ba4\u7f51\u7ad9<\/strong><\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u672c\u516c\u4f17\u53f7\u4e0a\u7684\u5f80\u671f\u6587\u7ae0\u540c\u6b65\u53d1\u5e03\u81f3\u5bf9\u5e94\u7f51\u7ad9OncoLab\u5b9e\u9a8c\u5ba4\u3002<\/p>\n

\u7f51\u7ad9\u81ea\u5e26\u68c0\u7d22\u529f\u80fd\uff0c\u53ef\u4ee5\u6839\u636e\u5173\u952e\u8bcd\u8fdb\u884c\u68c0\u7d22<\/span>\uff0c\u5e76\u4e14\u53ef\u4ee5\u6839\u636e\u65e5\u671f\u53ca\u5185\u5bb9\u5206\u7c7b<\/span>\u8fdb\u884c\u67e5\u770b ,\u5927\u5bb6\u53ef\u4ee5\u6536\u85cf\u65b9\u4fbf\u5728\u7535\u8111\u4e0a\u67e5\u770b\u3002<\/p>\n

\u7f51\u5740\u662f\uff1aoncolab.cn<\/span><\/strong><\/p>\n<\/section>\n

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\u2589  OncoLab\u5b66\u672f\u5bfc\u822a<\/strong><\/strong><\/p>\n

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\u6b64\u5916\uff0c\u68b3\u7406\u4e86\u4e00\u4e0b\u8fd9\u51e0\u5e74\u6512\u7684\u6536\u85cf\u5939\uff0c\u505a\u4e86\u4e00\u4e2a\u5bfc\u822a\u7f51\u9875\uff0c\u5305\u542b\u5e38\u7528\u7f51\u7ad9<\/span>\u3001\u6587\u732e\u9605\u8bfb<\/span>\u3001\u8bd5\u5242\u8ba2\u8d2d<\/span>\u3001\u57fa\u91d1\u76f8\u5173<\/span>\u3001\u5b9e\u7528\u5de5\u5177<\/span>\u3001\u5e38\u7528\u6570\u636e\u5e93<\/span>\u7b49\u5206\u7c7b\u5185\u5bb9\uff0c\u5e76\u4e14\u6574\u5408\u4e86<\/span>\u767e\u5ea6\u3001\u8c37\u6b4c\u3001\u5fc5\u5e94<\/span>\u4e09\u5927\u641c\u7d22\u5f15\u64ce\u5230\u68c0\u7d22\u5de5\u5177\u4e2d\uff0c\u6b22\u8fce\u6536\u85cf\u6216\u8bbe\u7f6e\u4e3a\u4e3b\u9875\u4f7f\u7528~<\/span><\/p>\n

\u7f51\u5740\u662f\uff1adh.<\/strong><\/span>oncolab.cn<\/span><\/strong><\/p>\n<\/section>\n

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