{"id":5638,"date":"2024-05-26T21:22:49","date_gmt":"2024-05-26T13:22:49","guid":{"rendered":"http:\/\/dh.oncolab.cn\/index.php\/2024\/05\/26\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac28%e7%ab%a0%ef%bc%9a%e8%82%bf%e7%98%a4%e7%9a%84%e5%b1%80%e9%83%a8%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%ef%bc%88%e4%b8%8a%ef%bc%89\/"},"modified":"2024-05-26T21:22:49","modified_gmt":"2024-05-26T13:22:49","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac28%e7%ab%a0%ef%bc%9a%e8%82%bf%e7%98%a4%e7%9a%84%e5%b1%80%e9%83%a8%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%ef%bc%88%e4%b8%8a%ef%bc%89","status":"publish","type":"post","link":"http:\/\/dh.oncolab.cn\/index.php\/2024\/05\/26\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac28%e7%ab%a0%ef%bc%9a%e8%82%bf%e7%98%a4%e7%9a%84%e5%b1%80%e9%83%a8%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%ef%bc%88%e4%b8%8a%ef%bc%89\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c28\u7ae0\uff1a\u80bf\u7624\u7684\u5c40\u90e8\u514d\u75ab\u6cbb\u7597\uff08\u4e0a\uff09"},"content":{"rendered":"
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\u4e0a\u671f\u5185\u5bb9\uff1a\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c27\u7ae0\uff1a\u80a0\u9053\u83cc\u7fa4\u5bf9\u764c\u75c7\u6cbb\u7597\u53cd\u5e94\u7684\u5f71\u54cd\uff08\u4e0b\uff09<\/span><\/a><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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28.1 \u5f15\u8a00<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5229\u7528\u514d\u75ab\u523a\u6fc0\u6765\u6839\u6cbb\u764c\u75c7\u5e76\u4e0d\u662f\u4e00\u4e2a\u65b0\u6982\u5ff5\u3002\u65e9\u572819\u4e16\u7eaa\u4e2d\u53f6\uff0c\u5fb7\u56fd\u5185\u79d1\u533b\u751fW. Busch\u5c31\u89c2\u5bdf\u5230\uff0c\u4e00\u540d\u611f\u67d3\u5316\u8113\u6027\u94fe\u7403\u83cc\u7684\u60a3\u8005\u5728\u60a3\u4e0a\u4e25\u91cd\u7684\u4e39\u6bd2\u540e\uff0c\u5176\u764c\u75c7\u663e\u8457\u6d88\u9000\u3002\u8fd9\u4e00\u53d1\u73b0\u4fc3\u4f7f\u5a01\u5ec9\u00b7\u79d1\u5229\u535a\u58eb\u5c06\u5316\u8113\u6027\u94fe\u7403\u83cc\u63d0\u53d6\u7269\u6ce8\u5c04\u5230\u764c\u75c7\u60a3\u8005\u4f53\u5185\uff0c\u8fd9\u79cd\u65b9\u6cd5\u540e\u6765\u88ab\u79f0\u4e3a\u201c\u79d1\u5229\u6bd2\u7d20\u201d\u3002\u79d1\u5229\u535a\u58eb\u548c\u5176\u4ed6\u4eba\u5bf9\u6b64\u65b9\u6cd5\u53d6\u5f97\u4e86\u4e0d\u540c\u7a0b\u5ea6\u7684\u6210\u529f\u3002\u867d\u7136\u8fd9\u79cd\u7597\u6cd5\u968f\u7740\u653e\u5c04\u6cbb\u7597\u7684\u5f15\u5165\u9010\u6e10\u5931\u5ba0\uff0c\u4f46\u57fa\u4e8e\u8fd9\u4e9b\u53d1\u73b0\u7684\u8f83\u65b0\u5b9e\u9a8c\u8868\u660e\uff0c\u5185\u6bd2\u7d20\u53ef\u4ee5\u8bf1\u5bfc\u663e\u8457\u7684\u514d\u75ab\u53cd\u5e94\u3002\u65e9\u671f\u8bd5\u9a8c\u663e\u793a\u4e86\u4e00\u4e9b\u4e34\u5e8a\u53cd\u5e94\uff0c\u4f46\u7531\u4e8e\u6bd2\u6027\u8f83\u9ad8\uff0c\u8fd9\u79cd\u65b9\u6cd5\u4e00\u5ea6\u88ab\u6401\u7f6e\u3002\u7136\u800c\uff0c\u8fd9\u4e9b\u53cd\u5e94\u8bc1\u660e\u4e86\u7528\u5f3a\u70c8\u7684\u4fc3\u708e\u523a\u6fc0\u6fc0\u6d3b\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u7684\u53ef\u80fd\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u8fc7\u53bb\u5341\u5e74\u91cc\uff0c\u764c\u75c7\u514d\u75ab\u6cbb\u7597\u53d6\u5f97\u4e86\u663e\u8457\u8fdb\u5c55\u3002\u9488\u5bf9CTLA-4\u548cPD-1\/PD-L1\u514d\u75ab\u68c0\u67e5\u70b9\u7684\u591a\u79cd\u5355\u514b\u9686\u6297\u4f53\u5df2\u83b7\u6279\u51c6\uff0c\u8bb8\u591a\u5176\u4ed6\u514d\u75ab\u68c0\u67e5\u70b9\u7684\u5c0f\u5206\u5b50\u548c\u5355\u514b\u9686\u6297\u4f53\u4e5f\u5728\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u53d6\u5f97\u4e86\u5feb\u901f\u8fdb\u5c55\u3002\u8fd9\u4e9b\u7597\u6cd5\u4f9d\u8d56\u4e8e\u91cd\u65b0\u6fc0\u6d3b\u88ab\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u7684\u514d\u75ab\u6291\u5236\u673a\u5236\u6240\u6c89\u9ed8\u7684\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u3002\u56e0\u6b64\uff0c\u4e0d\u51fa\u6240\u6599\uff0c\u6700\u663e\u8457\u7684\u4e34\u5e8a\u53cd\u5e94\u51fa\u73b0\u5728\u9ad8\u514d\u75ab\u539f\u6027\u80bf\u7624\u4e2d\uff0c\u8fd9\u4e9b\u80bf\u7624\u5177\u6709\u8f83\u9ad8\u7684\u7a81\u53d8\u8d1f\u62c5\u548c\u4e00\u4e9b\u53ef\u80fd\u7684\u65b0\u6297\u539f\uff0c\u4f8b\u5982\u5438\u70df\u8005\u7684\u9ed1\u8272\u7d20\u7624\u548c\u975e\u5c0f\u7ec6\u80de\u80ba\u764c(NSCLC)\u3002\u6b64\u5916\uff0c\u5728\u5177\u6709\u56fa\u6709\u514d\u75ab\u6d78\u6da6\u6027\u7684\u80bf\u7624\u4e2d\uff0c\u4f8b\u5982\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u548c\u5f25\u6f2b\u6027\u5927B\u7ec6\u80de\u6dcb\u5df4\u7624(DLBCL)\u7684\u4e00\u4e9b\u4e9a\u578b\uff0c\u901a\u8fc7\u80bf\u7624\u7ec6\u80de\u4e0aPD-L1\u7684\u9ad8\u8868\u8fbe\uff0c\u4e5f\u89c2\u5bdf\u5230\u663e\u8457\u7684\u4e34\u5e8a\u53cd\u5e94\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5c3d\u7ba1\u5982\u6b64\uff0c\u5bf9\u4e8e\u5927\u591a\u6570\u5df2\u83b7\u6279\u4f7f\u7528\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6cbb\u7597\u7684\u5b9e\u4f53\u764c\u75c7\u60a3\u8005\uff08\u5982\u80ba\u764c\u3001\u8180\u80f1\u764c\u3001\u80be\u7ec6\u80de\u764c\u548c\u9ed1\u8272\u7d20\u7624\uff09\uff0c\u7531\u4e8e\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u8fc7\u5f3a\u7684\u514d\u75ab\u6291\u5236\u6216\u514d\u75ab\u53cd\u5e94\u592a\u5f31\uff0c\u96be\u4ee5\u4ea7\u751f\u5168\u8eab\u6027\u514d\u75ab\u53cd\u5e94\u548c\u663e\u8457\u7684\u80bf\u7624\u6d88\u9000\u3002\u652f\u6301\u8fd9\u4e00\u7406\u8bba\u7684\u8bc1\u636e\u8868\u660e\uff0c\u8bb8\u591a\u5b9e\u4f53\u80bf\u7624\u7684\u201c\u708e\u75c7\u201d\u8868\u578b\u548c\u663e\u8457\u7684\u514d\u75ab\u7ec6\u80de\u6d78\u6da6\u7a0b\u5ea6\u9884\u6d4b\u4e86\u5bf9\u514d\u75ab\u6cbb\u7597\u7684\u53cd\u5e94\u3002\u8fd9\u4e9b\u53d1\u73b0\u63d0\u793a\uff0c\u5728\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u8bf1\u5bfc\u708e\u75c7\u7684\u540c\u65f6\uff0c\u7ed3\u5408\u6291\u5236\u68c0\u67e5\u70b9\u7684\u65b9\u6cd5\uff0c\u5c06\u589e\u5f3a\u5bf9\u80bf\u7624\u6297\u539f\u7684\u514d\u75ab\u53cd\u5e94\uff0c\u5e76\u63d0\u9ad8\u4e34\u5e8a\u5e94\u7b54\u7387\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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CTLA-4\u548cPD-1\u963b\u6ede\u5242\u7684\u7597\u6548\uff0c\u7279\u522b\u662f\u5728\u8054\u5408\u4f7f\u7528\u65f6\uff0c\u660e\u786e\u663e\u793a\u4e86\u5176\u6210\u529f\u7684\u6f5c\u529b\u3002\u7136\u800c\uff0c\u8fd9\u4e9b\u53cc\u91cd\u7597\u6cd5\u5177\u6709\u663e\u8457\u7684\u6bd2\u6027\uff0c\u5e76\u4e14\u76ee\u524d\u4ec5\u5728\u9ad8\u514d\u75ab\u539f\u6027\u80bf\u7624\u4e2d\u8fbe\u5230\u63a5\u8fd150%\u7684\u5e94\u7b54\u7387\u3002\u4e3a\u63d0\u9ad8\u7597\u6548\u4e0e\u964d\u4f4e\u6bd2\u6027\uff0c\u6b63\u5728\u7814\u7a76\u5927\u91cf\u66ff\u4ee3\u7ec4\u5408\u65b9\u6cd5\u3002\u5176\u4e2d\u4e00\u4e2a\u6709\u524d\u666f\u7684\u7c7b\u522b\u662f\u75ab\u82d7\u63a5\u79cd\uff0c\u8fd9\u7c7b\u4f3c\u4e8e\u4f20\u7edf\u75ab\u82d7\uff0c\u901a\u8fc7\u5728\u80bf\u7624\u76f8\u5173\u6297\u539f\uff08TAA\uff09\u7684\u57fa\u7840\u4e0a\u5f15\u5165\u514d\u75ab\u4f50\u5242\uff0c\u5c06\u514d\u75ab\u53cd\u5e94\u96c6\u4e2d\u5728\u764c\u75c7\u7279\u5f02\u6027\u9776\u70b9\u4e0a\u3002<\/p>\n

\u8bb8\u591a\u4f53\u5916\u65b9\u6cd5\u5df2\u7ecf\u663e\u793a\u51fa\u6709\u6548\u6027\uff0c\u8fd9\u4e9b\u65b9\u6cd5\u4f9d\u8d56\u4e8e\u6297\u539f\u63d0\u5448\u7ec6\u80de\uff08APC\uff09\u4e0e\u7279\u5b9a\u7684TAA\u6216\u6574\u4e2a\u80bf\u7624\u88c2\u89e3\u7269\u7684\u4f53\u5916\u5206\u5316\uff0c\u6216\u8005\u4f9d\u8d56\u4e8e\u5bf9TAA\u6709\u53cd\u5e94\u7684\u80bf\u7624\u6d78\u6da6\u6027\u6dcb\u5df4\u7ec6\u80de\u7684\u4f53\u5916\u6269\u589e\u3002\u5c3d\u7ba1\u8fd9\u4e9b\u4f53\u5916\u65b9\u6cd5\u7684\u5c0f\u89c4\u6a21\u7814\u7a76\u663e\u793a\u4e86\u5f3a\u5927\u7684\u4e34\u5e8a\u53cd\u5e94\uff0c\u4f46\u7531\u4e8e\u5176\u8d44\u6e90\u5bc6\u96c6\u578b\u7684\u7279\u6027\uff0c\u96be\u4ee5\u4f18\u5316\u548c\u5927\u89c4\u6a21\u5e94\u7528\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e00\u79cd\u66ff\u4ee3\u65b9\u6cd5\u662f\u539f\u4f4d\u75ab\u82d7\u63a5\u79cd\uff08ISV\uff09\uff0c\u5373\u5728\u80bf\u7624\u5185\u521b\u5efa\u4e00\u79cd\u201c\u75ab\u82d7\u201d\uff0c\u4ee5\u5b9e\u73b0\u4e0e\u4f53\u5916\u6280\u672f\u76f8\u540c\u7684\u76ee\u6807\u3002\u5177\u4f53\u6765\u8bf4\uff0c\u8fd9\u4e9b\u7597\u6cd5\u65e8\u5728\u901a\u8fc7\u5bf9\u764c\u7ec6\u80de\u7684\u635f\u4f24\uff0c\u968f\u540e\u6444\u53d6\u548c\u5904\u7406\u91ca\u653e\u7684\u80bf\u7624\u6297\u539f\u548c\u523a\u6fc0\u6027\u201c\u635f\u4f24\u201d\u76f8\u5173\u5206\u5b50\uff0c\u6700\u7ec8\u5c06\u6297\u539f\u5448\u9012\uff08\u53ca\u4ea4\u53c9\u5448\u9012\uff09\u7ed9CD4\u548cCD8 T\u7ec6\u80de(Fig 28.1<\/span>)\u3002<\/p>\n

\u6cbb\u7597ISV\u7684\u65b9\u6cd5\u6709\u591a\u79cd\uff0c\u4f46\u5176\u4e00\u822c\u539f\u7406\u662f\u76f8\u540c\u7684\uff0c\u7279\u522b\u662f\uff1a(1)\u8bf1\u5bfc\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\uff1b(2)\u767d\u7ec6\u80de\u91cd\u65b0\u805a\u96c6\uff0c\u8bf1\u5bfc\u514d\u75ab\u6cbb\u7597\u53cd\u5e94\u7684\u201c\u708e\u75c7\u201d\u8868\u578b\uff1b(3)\u6fc0\u6d3bAPC\uff0c\u5bfc\u81f4\u56fa\u6709\u6dcb\u5df4\u7ec6\u80de\u7684\u6fc0\u6d3b\u548cTAA\u5448\u9012\u7ed9\u6297\u539f\u7279\u5f02\u6027\u6548\u5e94\u7ec6\u80de\uff1b\u4ee5\u53ca(4)\u8c03\u8282\u6216\u6d88\u9664\u514d\u75ab\u6291\u5236\u7684\u80bf\u7624\u5fae\u73af\u5883\u3002\u5728\u8fd9\u91cc\uff0c\u6211\u4eec\u56de\u987e\u4e86\u5b9e\u73b0\u8fd9\u56db\u4e2a\u76ee\u6807\u7684\u4e00\u4e9b\u65b9\u6cd5\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 28.1<\/span> \u8bf1\u5bfc\u80bf\u7624\u6297\u539f\u539f\u4f4d\u514d\u75ab\u53cd\u5e94\u7684\u6838\u5fc3\u673a\u5236\u3002\u9996\u5148\uff0c\u901a\u8fc7\u523a\u6fc0\u5f15\u8d77\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\u3002\u8fd9\u4e00\u8fc7\u7a0b\u5bfc\u81f4\u9a7b\u7559\u6216\u88ab\u62db\u52df\u7684\u6297\u539f\u63d0\u5448\u7ec6\u80de\uff08APC\uff09\u5438\u6536\u6297\u539f\uff0c\u5e76\u5728\u4fc3\u708e\u4fe1\u53f7\u7684\u4f5c\u7528\u4e0b\u88ab\u6fc0\u6d3b\u3002\u4fc3\u708e\u4fe1\u53f7\u65e2\u6e90\u81ea\u5148\u5929\u514d\u75ab\u53cd\u5e94\uff0c\u53c8\u6709\u52a9\u4e8e\u6297\u539f\u7684\u5904\u7406\u548c\u5448\u9012\/\u4ea4\u53c9\u5448\u9012\uff0c\u4ece\u800c\u5f15\u53d1\u9002\u5e94\u6027\u514d\u75ab\u53cd\u5e94\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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28.2 \u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\uff08ICD\uff09\u5bfc\u81f4\u80bf\u7624\u6297\u539f\u4ece\u6b7b\u4ea1\u7ec6\u80de\u4e2d\u91ca\u653e\u5230\u5fae\u73af\u5883\u4e2d\uff0c\u5e76\u4f34\u968f\u7740\u6fc0\u6d3b\u6297\u539f\u63d0\u5448\u7ec6\u80de\uff08APC\uff09\u7684\u7ec6\u80de\u5e94\u6fc0\u4fe1\u53f7\u548c\u635f\u4f24\u76f8\u5173\u5206\u5b50\u6a21\u5f0f\uff08DAMP\uff09\u3002\u4e0e\u7ec6\u80de\u51cb\u4ea1\u7684\u514d\u75ab\u8010\u53d7\u4e0d\u540c\uff0cICD\u4e0d\u4ec5\u63d0\u4f9b\u6297\u539f\uff0c\u8fd8\u63d0\u4f9b\u708e\u75c7\u523a\u6fc0\u3002\u56e0\u6b64\uff0c\u8bf1\u5bfc\u8fd9\u79cd\u5f62\u5f0f\u7ec6\u80de\u6b7b\u4ea1\u7684\u836f\u7269\u6709\u65f6\u80fd\u591f\u81ea\u884c\u5f15\u53d1\u75ab\u82d7\u53cd\u5e94\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5c3d\u7ba1\u514d\u75ab\u7597\u6cd5\u901a\u5e38\u88ab\u63cf\u8ff0\u4e3a\u5177\u6709\u4e0d\u540c\u7684\u673a\u5236\uff0c\u4f46\u5b9e\u9645\u4e0a\uff0c\u8bb8\u591a\u5728\u4e0a\u4e2a\u4e16\u7eaa\u4f7f\u7528\u7684\u7ec6\u80de\u6bd2\u6027\u7597\u6cd5\u53ef\u80fd\u5df2\u7ecf\u5305\u542b\u4e86\u514d\u75ab\u523a\u6fc0\u6210\u5206\u3002\u5bf9\u514d\u75ab\u7cfb\u7edf\u5728\u764c\u75c7\u4e2d\u7684\u4f5c\u7528\u7684\u65e9\u671f\u89c2\u5bdf\u5305\u62ec\u975e\u8303\u56f4\u6548\u5e94\uff0c\u5373\u7ed9\u4e88\u60a3\u8005\u5c40\u90e8\u653e\u5c04\u6cbb\u7597\u5bfc\u81f4\u8fdc\u79bb\u8f90\u5c04\u533a\u57df\u7684\u75be\u75c5\u6d88\u9000\u3002\u867d\u7136\u8fd9\u79cd\u73b0\u8c61\u7f55\u89c1\uff0c\u4f46\u63d0\u4f9b\u4e86\u8fdb\u4e00\u6b65\u4f18\u5316\u7684\u539f\u7406\u4f9d\u636e\u3002\u7531\u4e8e\u8f90\u5c04\u80fd\u591f\u8bf1\u5bfcICD\uff0c\u56e0\u6b64\u5df2\u88ab\u7528\u4e8e\u5404\u79cd\u75ab\u82d7\/\u514d\u75ab\u6cbb\u7597\u65b9\u6848\u4e2d\u3002<\/p>\n

\u8f90\u5c04\u4f1a\u523a\u6fc0\u9499\u7f51\u86cb\u767d\u8f6c\u4f4d\u5230\u7ec6\u80de\u8868\u9762\uff0c\u5e76\u91ca\u653e\u5927\u91cf\u7684\u6f6e\u6e7f\u7269\u8d28\uff0c\u5305\u62ec\u6e38\u79bbDNA\u3001\u9ad8\u8fc1\u79fb\u7387\u65cf\u86cb\u767d1\uff08HMGB1\uff09\u548cATP\u3002\u8fd9\u4e9b\u4fe1\u53f7\u523a\u6fc0\u6811\u7a81\u72b6\u7ec6\u80de\uff08DC\uff09\u4e0a\u7684\u4fc3\u708e\u53d7\u4f53\uff0c\u6fc0\u6d3b\u708e\u75c7\u4f53\u548cToll\u6837\u53d7\u4f53\uff08TLR\uff09\u9014\u5f84\u4ee5\u53ca\u5176\u4ed6\u6a21\u5f0f\u8bc6\u522b\u53d7\u4f53\uff08PRRs\uff09\u3002\u5f53\u6b7b\u4ea1\u6216\u6fd2\u4e34\u6b7b\u4ea1\u7684\u80bf\u7624\u7ec6\u80de\u88ab\u541e\u566c\u7ec6\u80de\u6444\u53d6\u65f6\uff0c\u65e0\u7ec6\u80deDNA\u8fd8\u80fd\u6fc0\u6d3b\u5e72\u6270\u7d20\u57fa\u56e0\u523a\u6fc0\u7269\uff08STING\uff09\u9014\u5f84\uff0c\u8bf1\u5bfc\u5e72\u6270\u7d20\u7684\u4ea7\u751f\uff0c\u5e76\u589e\u5f3a\u5f3a\u6548T\u7ec6\u80de\u7684\u6fc0\u6d3b\u3002\u540c\u65f6\uff0c\u8f90\u5c04\u8fdb\u4e00\u6b65\u8bf1\u5bfc\u5173\u952e\u8d8b\u5316\u56e0\u5b50\u7684\u8868\u8fbe\uff0c\u5305\u62ecCXCL9\u3001CXCL10\u548cCXCL16\uff0c\u8fd9\u4e9b\u8d8b\u5316\u56e0\u5b50\u5bf9\u4e8e\u6548\u5e94CD8+ T\u7ec6\u80de\u5728\u53d7\u7167\u5c04\u80bf\u7624\u4e2d\u7684\u52df\u96c6\u81f3\u5173\u91cd\u8981\u3002<\/p>\n

\u7136\u800c\uff0c\u8f90\u5c04\u4e5f\u88ab\u8bc1\u660e\u80fd\u591f\u901a\u8fc7\u52df\u96c6\u548c\u5206\u5316\u8c03\u8282\u6027T\u7ec6\u80de\u548c\u9ad3\u6e90\u6027\u6291\u5236\u7ec6\u80de\uff08MDSC\uff09\u5230\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u6765\u6291\u5236\u514d\u75ab\u53cd\u5e94\u3002\u8fd9\u4f1a\u5bfc\u81f4\u7ec6\u80de\u56e0\u5b50\u5982\u8f6c\u5316\u751f\u957f\u56e0\u5b50-\u03b2\u7684\u5206\u6ccc\uff0c\u5e76\u901a\u8fc7CD39\u548cCD73\u5c06\u514d\u75ab\u539f\u6027ATP\u8f6c\u5316\u4e3a\u817a\u82f7\uff0c\u4ece\u800c\u901a\u8fc7A2a\u817a\u82f7\u53d7\u4f53\u6291\u5236T\u6548\u5e94\u7ec6\u80de\u7684\u6fc0\u6d3b\u548c\u5b58\u6d3b\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7814\u7a76\u4eba\u5458\u5df2\u7ecf\u8bc1\u660e\uff0c\u80bf\u7624\u5185\u7684T\u7ec6\u80de\u548c\u80bf\u7624\u7ec6\u80de\u5728\u63a5\u53d7\u7535\u79bb\u8f90\u5c04\u540e\uff0cPD-1\u548cPD-L1\u7684\u8868\u8fbe\u663e\u8457\u4e0a\u8c03\u3002\u867d\u7136\u8fd9\u4e9b\u548c\u5176\u4ed6\u6291\u5236\u6027\u914d\u4f53\u4e5f\u662fT\u7ec6\u80de\u6fc0\u6d3b\u7684\u6807\u5fd7\uff0c\u4f46T\u7ec6\u80de\u5728\u6fc0\u6d3b\u65f6\u4e0a\u8c03\u8fd9\u4e9b\u914d\u4f53\u548c\u53d7\u4f53\uff0c\u4f5c\u4e3a\u5bf9\u514d\u75ab\u7cfb\u7edf\u7684\u751f\u7406\u68c0\u67e5\u4ee5\u907f\u514d\u81ea\u8eab\u514d\u75ab\u3002\u8fd9\u53ef\u80fd\u89e3\u91ca\u4e86\u4e34\u5e8a\u4e0a\u76f8\u5173\u7684\u975e\u8303\u56f4\u6548\u5e94\u7684\u7f55\u89c1\u6027\uff0c\u5e76\u4e3a\u4f7f\u7528\u653e\u5c04\u6cbb\u7597\u7684\u7ec4\u5408\u65b9\u6cd5\u63d0\u4f9b\u4e86\u5408\u7406\u7684\u9776\u70b9\u3002\u8bb8\u591a\u4e34\u5e8a\u524d\u7814\u7a76\u8868\u660e\uff0c\u653e\u5c04\u6cbb\u7597\uff08RT\uff09\u4e0e\u68c0\u67e5\u70b9\u963b\u65ad\u7597\u6cd5\u5177\u6709\u534f\u540c\u4f5c\u7528\uff0c\u5c3d\u7ba1\u4e34\u5e8a\u6210\u529f\u6709\u9650\u3002\u5230\u76ee\u524d\u4e3a\u6b62\uff0c\u5927\u591a\u6570\u7814\u7a76\u96c6\u4e2d\u5728CTLA-4\u4e0a\uff0c\u4f46\u4e5f\u6709\u4ee4\u4eba\u9f13\u821e\u7684\u4e34\u5e8a\u524d\u7814\u7a76\u5c06\u653e\u5c04\u4e0ePD-1\u548c\u5176\u4ed6\u5173\u952e\u68c0\u67e5\u70b9\u53ca\u514d\u75ab\u6291\u5236\u9014\u5f84\u7684\u963b\u65ad\u76f8\u7ed3\u5408\uff08Kang\u7b49\u4eba\u5e7f\u6cdb\u56de\u987e\u4e86\u8fd9\u4e9b\u7814\u7a76\uff09\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u867d\u7136\u653e\u7597\u548c\u5316\u7597\u901a\u5e38\u90fd\u88ab\u8ba4\u4e3a\u662f\u6dcb\u5df4\u6bd2\u6027\u7684\uff0c\u4f46\u5316\u7597\u4e5f\u53ef\u4ee5\u4f5c\u4e3a\u514d\u75ab\u6cbb\u7597\u7684\u4f50\u5242\u53d1\u6325\u591a\u91cd\u4f5c\u7528\u3002\u50cf\u653e\u5c04\u4e00\u6837\uff0c\u5316\u7597\u4f1a\u5bfc\u81f4ICD\uff0c\u91ca\u653e\u514d\u75ab\u539f\u6027\u914d\u4f53\u548c\u80bf\u7624\u6297\u539f\uff0c\u8fd9\u4e9b\u6297\u539f\u53ef\u4ee5\u88ab\u80bf\u7624\u5185\u7684APC\u53ca\u5468\u56f4\u7ec4\u7ec7\u548c\u5f15\u6d41\u6dcb\u5df4\u7ed3\u6444\u53d6\u3002Kepp\u7b49\u4eba\u5e7f\u6cdb\u56de\u987e\u4e86\u8fd9\u4e00\u70b9\u3002\u9664\u4e86\u80bf\u7624\u7ec6\u80de\u6bd2\u6027\uff0c\u6dcb\u5df4\u6bd2\u6027\u5316\u7597\uff0c\u5982\u73af\u78f7\u9170\u80fa\uff0c\u5df2\u88ab\u53d1\u73b0\u4f18\u5148\u8017\u5c3d\u8c03\u8282\u6027T\u7ec6\u80de\uff08Tregs\uff09\uff0c\u5bf9T\u6548\u5e94\u7ec6\u80de\u7684\u5f71\u54cd\u8f83\u5c0f\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\u65b9\u9762\u7684\u6743\u5a01Kroemer\u6559\u6388\u5728\u672c\u7cfb\u5217\u7684\u5176\u4ed6\u90e8\u5206\u56de\u987e\u4e86\u5316\u7597\u5728\u542f\u52a8\u514d\u75ab\u53cd\u5e94\u7684\u521d\u59cb\u6b65\u9aa4\u4e2d\u7684\u4f5c\u7528\uff0c\u4ee5\u53ca\u65b0\u65e7\u7ec6\u80de\u6bd2\u6027\u5316\u7597\u4e0e\u65b0\u5174\u514d\u75ab\u7597\u6cd5\u7ed3\u5408\u6240\u8d77\u7684\u4f5c\u7528\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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

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28.3 \u514d\u75ab\u7ec6\u80de\u7684\u62db\u52df<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e34\u5e8a\u4e0a\uff0c21\u540d\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u81ea\u4f53\u80bf\u7624\u7ec6\u80de\u88ab\u8f6c\u5bfc\u4ee5\u8868\u8fbeGM-CSF\uff0c\u968f\u540e\u7684\u80bf\u7624\u6d3b\u68c0\u663e\u793a\u5927\u591a\u6570\u60a3\u8005\u6709\u66f4\u591a\u7684T\u7ec6\u80de\u6d78\u6da6\uff0c\u4ee5\u53ca\u80bf\u7624\u574f\u6b7b\u3001\u7ea4\u7ef4\u5316\u548c\u6c34\u80bf\u3002\u7c7b\u4f3c\u7684\u514d\u75ab\u53cd\u5e94\u5728\u5bf9\u9ed1\u8272\u7d20\u7624\u3001\u80ba\u764c\u548c\u524d\u5217\u817a\u764c\u60a3\u8005\u7684\u81ea\u4f53GM-CSF\u8f6c\u5bfc\u80bf\u7624\u7ec6\u80de\u7684\u8bd5\u9a8c\u4e2d\u4e5f\u6709\u6240\u89c2\u5bdf\u3002GM-CSF\u4e0e\u4fc3\u8fdb\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\u7684\u6cbb\u7597\u76f8\u7ed3\u5408\uff0c\u4e5f\u663e\u793a\u4e86\u8bf1\u5bfc\u6297\u80bf\u7624\u514d\u75ab\u7684\u4f5c\u7528\u3002\u4e00\u9879\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624\u7684\u539f\u4f4d\u75ab\u82d7\uff08ISV\uff09\u8bd5\u9a8c\u7ed3\u5408\u4e86\u5c40\u90e8\u653e\u7597\u548c\u7624\u5185\u6ce8\u5c04\u672a\u6210\u719f\u7684\u81ea\u4f53\u6811\u7a81\u72b6\u7ec6\u80de\u548cGM-CSF\uff0c\u7ed3\u679c\u663e\u793a36%\u7684\u603b\u6709\u6548\u7387\uff08ORR\uff09\uff0c\u5176\u4e2d\u90a3\u4e9b\u6709\u53ef\u6d4b\u91cf\u7684\u80bf\u7624\u5bfc\u5411CD8+\u53cd\u5e94\u7684\u60a3\u8005\u6709\u6700\u663e\u8457\u548c\u6301\u4e45\u7684\u4e34\u5e8a\u53cd\u5e94\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u867d\u7136DC\u7684\u5438\u5f15\u548c\u6210\u719f\u5bfc\u81f4\u4e86\u4fc3\u708e\u514d\u75ab\u4fe1\u53f7\uff0c\u4f46\u80bf\u7624\u5185\u7684GM-CSF\u4e5f\u88ab\u53d1\u73b0\u5bf9\u4e2d\u6027\u7c92\u7ec6\u80de\u548c\u5176\u4ed6\u9ad3\u7cfb\u7ec6\u80de\u5177\u6709\u8d8b\u5316\u4f5c\u7528\uff0c\u80fd\u591f\u4fc3\u8fdb\u8840\u7ba1\u751f\u6210\u548c\u6291\u5236CD8+ T\u7ec6\u80de\u7684\u542f\u52a8\u3002\u6b64\u5916\uff0cGM-CSF\u901a\u8fc7\u589e\u5f3a\u57fa\u8d28\u91d1\u5c5e\u86cb\u767d\u9176\uff08MMPs\uff09\u7684\u8868\u8fbe\uff0c\u76f4\u63a5\u4fc3\u8fdb\u67d0\u4e9b\u80bf\u7624\u7684\u751f\u957f\u3002\u8fd9\u4e9b\u86cb\u767d\u9176\u6709\u52a9\u4e8e\u80bf\u7624\u7684\u751f\u957f\u3001\u8fc1\u79fb\u548c\u8f6c\u79fb\u3002<\/p>\n

\u4e00\u4e9b\u4eba\u7c7b\u548c\u5c0f\u9f20\u764c\u75c7\u88ab\u53d1\u73b0\u4f1a\u8868\u8fbeGM-CSF\u6216G-CSF\u53ca\u5176\u5404\u81ea\u7684\u53d7\u4f53\uff0c\u5bfc\u81f4\u81ea\u5206\u6ccc\u4fc3\u8fdb\u589e\u6b96\u3002\u4e00\u4e9b\u7814\u7a76\u8868\u660e\uff0cGM-CSF\u7684\u4f5c\u7528\u53ef\u80fd\u56e0\u6240\u6d89\u53ca\u7684\u7ec4\u7ec7\u800c\u5f02\uff0c\u56e0\u6b64\u5728\u67d0\u4e9b\u764c\u75c7\u4e2d\u5b83\u53ef\u80fd\u4f5c\u4e3a\u514d\u75ab\u4f50\u5242\u4f7f\u7528\uff0c\u800c\u5728\u5176\u4ed6\u764c\u75c7\u4e2d\u5219\u53ef\u80fd\u4fc3\u8fdb\u80bf\u7624\u751f\u957f\u5e76\u6291\u5236\u514d\u75ab\u53cd\u5e94\u3002\u5927\u91cf\u4eba\u7c7b\u7ed3\u76f4\u80a0\u764c\u57fa\u56e0\u9635\u5217\u8868\u660e\uff0c\u8d85\u8fc7\u4e09\u5206\u4e4b\u4e00\u7684\u764c\u75c7\u4ea7\u751fGM-CSF\uff0c\u800c\u4e14\u8840\u6e05\u4e2dGM-CSF\u6c34\u5e73\u5347\u9ad8\u7684\u7ed3\u76f4\u80a0\u764c\u60a3\u8005\u9884\u540e\u8f83\u5dee\u3002\u5728\u5934\u9888\u764c\u4e2d\uff0c\u8840\u6e05\u4e2dGM-CSF\u548c\u5176\u4ed6\u751f\u957f\u56e0\u5b50\u4e0e\u8f83\u5dee\u7684\u4fb5\u88ad\u548c\u9884\u540e\u76f8\u5173\uff1b\u7c7b\u4f3c\u5730\uff0c\u6d78\u6da6\u6027\u8180\u80f1\u764c\u5076\u5c14\u4f1a\u5206\u6cccGM-CSF\uff0c\u4e00\u4e9b\u60a3\u8005\u7684\u764c\u7ec6\u80de\u4e5f\u8868\u8fbeGM-CSF\u53d7\u4f53\uff0c\u8fd9\u4e9b\u90fd\u4e0e\u8f83\u5dee\u7684\u9884\u540e\u76f8\u5173\u3002\u767d\u7ec6\u80de\u589e\u591a\u548c\u8840\u6db2\u6216\u80bf\u7624\u6837\u672c\u4e2dGM-CSF\u6c34\u5e73\u5347\u9ad8\u4e5f\u89c1\u4e8e\u5404\u79cd\u5176\u4ed6\u764c\u75c7\uff0c\u5305\u62ec\u80ba\u764c\u548c\u591a\u5f62\u6027\u80f6\u8d28\u6bcd\u7ec6\u80de\u7624\uff0c\u8fd9\u4e9b\u764c\u75c7\u4e5f\u662f\u52a0\u5165GM-CSF\u7684\u514d\u75ab\u6cbb\u7597\u8bd5\u9a8c\u7684\u9776\u70b9\u3002\u8fd9\u4e9b\u6570\u636e\u63d0\u793a\u9700\u8981\u8003\u8651\u80fd\u591f\u5206\u5316\u6216\u62db\u52dfAPC\u5230\u80bf\u7624\u90e8\u4f4d\u7684\u66ff\u4ee3\u751f\u957f\u56e0\u5b50\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8bb8\u591a\u4e34\u5e8a\u524d\u7814\u7a76\u5df2\u7ecf\u8bc1\u660e\u4e86Flt3L\u52a8\u5458\u514d\u75ab\u7ec6\u80de\u4e9a\u7fa4\u7684\u80fd\u529b\uff0c\u5176\u4e2dDC\u5360\u4e3b\u5bfc\u5730\u4f4d\uff0c\u5305\u62ec\u663e\u793aFlt3L\u5728\u9ed1\u8272\u7d20\u7624\u3001\u6dcb\u5df4\u7624\u3001\u767d\u8840\u75c5\u3001\u4e73\u817a\u764c\u3001\u7ed3\u80a0\u764c\u3001\u524d\u5217\u817a\u764c\u3001\u80ba\u764c\u548c\u809d\u7ec6\u80de\u764c\u4e2d\u7684\u6297\u80bf\u7624\u4f5c\u7528\u7684\u6a21\u578b\u3002\u5176\u4ed6\u6a21\u578b\u5df2\u7ecf\u8bc1\u660e\uff0c\u5355\u7528Flt3L\u65e0\u6548\uff0c\u800c\u6700\u4f73\u7684\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u9700\u8981\u8bf1\u5bfc\u6297\u539f\u91ca\u653e\u548cAPC\u523a\u6fc0\u7684\u7ec4\u5408\u65b9\u6cd5\u3002\u4f8b\u5982\uff0c\u5728\u4e73\u817a\u817a\u764c\u7684\u5c0f\u9f20\u6a21\u578b\u4e2d\uff0cFlt3L\u9884\u6fc0\u589e\u5f3a\u4e86\u4f4e\u5242\u91cf\u8f90\u5c04\u5f15\u8d77\u7684\u975e\u8303\u56f4\u6548\u5e94\uff0c\u4ee5T\u7ec6\u80de\u4f9d\u8d56\u7684\u65b9\u5f0f\u6d88\u9664\u4e86\u5168\u8eab\u80bf\u7624\u8d1f\u62c5\uff0c\u800cFlt3L\u5355\u72ec\u4f7f\u7528\u65e0\u6548\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e34\u5e8a\u4e0a\uff0c\u4e00\u9879I\u671f\u7814\u7a76\u8bc4\u4f30\u4e86\u81ea\u4f53DC\u7684\u4f7f\u7528\uff0c\u9996\u5148\u7528Flt3L\u5728\u4f53\u5185\u6269\u589e\uff0c\u7136\u540e\u4f53\u5916\u88c5\u8f7d\u764c\u80da\u6297\u539f\u80bd\uff0c\u518d\u8f93\u6ce8\u3002\u6cbb\u7597\u8010\u53d7\u6027\u826f\u597d\uff0c\u8bc1\u660eFlt3L\u6269\u589e\u7684DC\u662f\u539f\u6765\u768420\u500d\uff0c12\u540d\u60a3\u8005\u4e2d\u67092\u540d\u80bf\u7624\u663e\u8457\u6d88\u9000\u3002\u4e34\u5e8a\u53cd\u5e94\u4e0eCD8+ CEA\u56db\u805a\u4f53+ T\u7ec6\u80de\u7684\u6269\u589e\u76f8\u5173\uff0c\u8bc1\u5b9e\u4e86CD8+ T\u7ec6\u80de\u5728\u8be5\u6cbb\u7597\u7b56\u7565\u4e2d\u7684\u4f5c\u7528\u3002\u5728\u8179\u819c\u764c\u3001\u95f4\u76ae\u7624\u548c\u524d\u5217\u817a\u764c\u7684\u5176\u4ed6\u65e9\u671f\u8bd5\u9a8c\u4e2d\uff0c\u80bf\u7624\u5185\u548c\u5168\u8eab\u6811\u7a81\u72b6\u7ec6\u80de\u4e5f\u6709\u7c7b\u4f3c\u7684\u663e\u8457\u589e\u52a0\uff0c\u4e14\u6bd2\u6027\u6709\u9650\u3002\u8fd9\u4e9b\u65e9\u671f\u8bd5\u9a8c\u8868\u660e\uff0cFlt3L\u80fd\u591f\u663e\u8457\u589e\u52a0\u80bf\u7624\u5185APC\u7684\u5b58\u5728\u548c\u6d3b\u6027\uff0c\u4e14\u7c7b\u4f3c\u4e8eGM-CSF\uff0c\u8054\u5408\u6cbb\u7597\u5bf9\u4e8e\u542f\u52a8\u4e34\u5e8a\u7f13\u89e3\u662f\u5fc5\u8981\u7684\u3002<\/p>\n

\u5c3d\u7ba1Flt3L\u6cbb\u7597\u4fc3\u8fdb\u4e86DC\u7684\u7cfb\u7edf\u4ea7\u751f\u548c\u80bf\u7624\u5185\u7684\u6e17\u900f\uff0c\u4f46\u8fd9\u4e9bDC\u662f\u4e0d\u6210\u719f\u7684DC\uff0c\u7f3a\u4e4f\u6fc0\u6d3b\u6548\u5e94\u7ec6\u80de\u6240\u9700\u7684\u5171\u523a\u6fc0\u5206\u5b50\u3002\u8fd9\u65e2\u9650\u5236\u4e86\u5b83\u4eec\u4fc3\u8fdb\u6548\u5e94T\u7ec6\u80de\u53cd\u5e94\u7684\u80fd\u529b\uff0c\u53c8\u5b9e\u9645\u4e0a\u4fc3\u8fdb\u4e86\u8010\u53d7\u9014\u5f84\uff0c\u4f7f\u80bf\u7624\u7279\u5f02\u6027T\u7ec6\u80de\u4fdd\u6301\u9759\u6b62\u3002\u56e0\u6b64\uff0c\u867d\u7136Flt3L\u80fd\u591f\u589e\u52a0\u80bf\u7624\u5185DC\u7684\u6570\u91cf\uff0c\u4f46\u989d\u5916\u7684\u4fc3\u708e\u523a\u6fc0\u662f\u5fc5\u8981\u7684\uff0c\u4ee5\u5728\u5230\u8fbe\u65f6\u6fc0\u6d3b\u8fd9\u4e9bAPC\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u672c\u6587\u7531Oncolab\u5fae\u4fe1\u516c\u4f17\u53f7\u7ffb\u8bd1\u6574\u7406\u81eaOncoimmunology: A Practical Guide for Cancer Immunotherapy\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>
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\u2014 THE  END \u2014<\/span><\/p>\n


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\u6765\u6e90 | Oncoimmunology: A Practical Guide <\/span><\/p>\n

for Cancer Immunotherapy<\/span><\/p>\n

\u521d\u7a3f\u7ffb\u8bd1 | \u90d1\u68a6\u6021<\/span><\/p>\n

\u5ba1\u6838\u4fee\u6539 | \u738b\u5764<\/span><\/p>\n

\uff08\u8f6c\u8f7d\u8bf7\u4fdd\u7559\u6b64\u90e8\u5206\u5185\u5bb9\uff09<\/span><\/strong><\/p>\n


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