{"id":5659,"date":"2024-06-10T06:30:18","date_gmt":"2024-06-09T22:30:18","guid":{"rendered":"http:\/\/dh.oncolab.cn\/index.php\/2024\/06\/10\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac30%e7%ab%a0%ef%bc%9a%e6%94%be%e5%b0%84%e6%b2%bb%e7%96%97%e4%b8%8e%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%e7%9a%84%e5%8d%8f%e5%90%8c%e4%bd%9c\/"},"modified":"2024-06-10T06:30:18","modified_gmt":"2024-06-09T22:30:18","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac30%e7%ab%a0%ef%bc%9a%e6%94%be%e5%b0%84%e6%b2%bb%e7%96%97%e4%b8%8e%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%e7%9a%84%e5%8d%8f%e5%90%8c%e4%bd%9c","status":"publish","type":"post","link":"http:\/\/dh.oncolab.cn\/index.php\/2024\/06\/10\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac30%e7%ab%a0%ef%bc%9a%e6%94%be%e5%b0%84%e6%b2%bb%e7%96%97%e4%b8%8e%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%e7%9a%84%e5%8d%8f%e5%90%8c%e4%bd%9c\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c30\u7ae0\uff1a\u653e\u5c04\u6cbb\u7597\u4e0e\u514d\u75ab\u6cbb\u7597\u7684\u534f\u540c\u4f5c\u7528\uff08\u4e0a\uff09"},"content":{"rendered":"
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\u4e0a\u671f\u5185\u5bb9\uff1a\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c29\u7ae0 \u51cf\u5c11\u80bf\u7624\u5185\u8c03\u8282\u6027T\u7ec6\u80de\u7684\u7b56\u7565\uff08\u4e0b\uff09<\/span><\/a><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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30.1<\/strong> \u5f15\u8a00<\/strong><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u653e\u5c04\u6cbb\u7597\u4f5c\u4e3a\u4e00\u79cd\u6709\u6548\u7684\u764c\u7ec6\u80de\u6cbb\u7597\u65b9\u6cd5\uff0c\u5df2\u6709\u903e\u534a\u4e2a\u4e16\u7eaa\u7684\u5386\u53f2\u3002\u8fd9\u79cd\u7597\u6cd5\u7684\u4f18\u5316\u4e3b\u8981\u96c6\u4e2d\u4e8e\u5982\u4f55\u63d0\u9ad8\u80bf\u7624\u533a\u57df\u7684\u5242\u91cf\u7cbe\u786e\u5ea6\uff0c\u540c\u65f6\u6700\u5927\u9650\u5ea6\u5730\u4fdd\u62a4\u5468\u56f4\u6b63\u5e38\u7ec4\u7ec7\u3002\u8fd9\u4e00\u6311\u6218\u4fc3\u4f7f\u591a\u4ee3\u751f\u7269\u5b66\u5bb6\u548c\u4e34\u5e8a\u7814\u7a76\u8005\u6df1\u5165\u63a2\u8ba8\u8f90\u5c04\u4f24\u5bb3\u673a\u5236\u53ca\u4e0d\u540c\u7ec4\u7ec7\u7684\u4fee\u590d\u8fc7\u7a0b\u3002\u7ecf\u8fc7\u6570\u5341\u5e74\u7684\u57fa\u7840\u4e0e\u4e34\u5e8a\u7814\u7a76\uff0c\u6211\u4eec\u5df2\u7ecf\u660e\u786e\u4e86\u653e\u5c04\u5242\u91cf\u5206\u5e03\u7684\u57fa\u672c\u539f\u5219\uff0c\u80fd\u591f\u901a\u8fc7\u7cbe\u7ec6\u5316\u7684\u6cbb\u7597\u8ba1\u5212\uff0c\u5728\u5b89\u5168\u5730\u5bf9\u80bf\u7624\u65bd\u52a0\u81f4\u547d\u5242\u91cf\u7684\u540c\u65f6\uff0c\u5e2e\u52a9\u6b63\u5e38\u7ec4\u7ec7\u6062\u590d\u3002\u901a\u5e38\u8fd9\u79cd\u6cbb\u7597\u6301\u7eed\u6570\u5468\uff0c\u6bcf\u65e5\u8fdb\u884c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u968f\u7740\u6280\u672f\u7684\u4e0d\u65ad\u8fdb\u6b65\uff0c\u4f8b\u5982\u7ebf\u6027\u52a0\u901f\u5668\u7684\u5e94\u7528\uff0c\u73b0\u5728\u6211\u4eec\u80fd\u591f\u975e\u5e38\u7cbe\u786e\u5730\u5b9a\u4f4d\u80bf\u7624\u53ca\u5176\u5728\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u7684\u52a8\u6001\u53d8\u5316\uff0c\u8fd9\u4f7f\u5f97\u91c7\u7528\u66f4\u5927\u5242\u91cf\u7684\u8f90\u5c04\u6210\u4e3a\u53ef\u80fd\uff0c\u540c\u65f6\u4e5f\u66f4\u5b89\u5168\u3002\u8fd9\u79cd\u9ad8\u5242\u91cf\u7684\u5feb\u901f\u653e\u5c04\u6cbb\u7597\u4e0d\u4ec5\u4e3a\u60a3\u8005\u5e26\u6765\u4e86\u4fbf\u5229\uff0c\u800c\u4e14\u5728\u63a7\u5236\u80bf\u7624\u65b9\u9762\u5f80\u5f80\u80fd\u591f\u53d6\u5f97\u66f4\u4f73\u6548\u679c\u3002\u56e0\u5176\u7597\u6548\u4e0e\u5916\u79d1\u624b\u672f\u76f8\u5ab2\u7f8e\uff0c\u8fd9\u79cd\u65b9\u6cd5\u4e5f\u88ab\u79f0\u4e3a\u201c\u6d88\u878d\u6027\u653e\u5c04\u6cbb\u7597\u201d\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u5f53\u524d\u7684\u514d\u75ab\u80bf\u7624\u5b66\u65b0\u65f6\u4ee3\uff0c\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u8868\u660e\u514d\u75ab\u7cfb\u7edf\u662f\u6291\u5236\u80bf\u7624\u53d1\u5c55\u7684\u5173\u952e\u3002\u653e\u5c04\u6cbb\u7597\u5728\u6b64\u4e2d\u626e\u6f14\u4e86\u65b0\u7684\u89d2\u8272\uff0c\u5b83\u4e0d\u4ec5\u76f4\u63a5\u6740\u6b7b\u764c\u7ec6\u80de\uff0c\u8fd8\u80fd\u589e\u5f3a\u60a3\u8005\u5bf9\u514d\u75ab\u6cbb\u7597\u7684\u54cd\u5e94\u3002\u5728\u672c\u7ae0\u4e2d\uff0c\u6211\u4eec\u5c06\u56de\u987e\u653e\u5c04\u6cbb\u7597\u7684\u5f53\u524d\u6807\u51c6\uff0c\u5e76\u63a2\u8ba8\u5728\u63a5\u53d7\u514d\u75ab\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\u89c2\u5bdf\u5230\u7684\u4e00\u4e9b\u610f\u5916\u8fdc\u9694\u6548\u5e94\u3002\u6587\u7ae0\u8fd8\u5c06\u4ecb\u7ecd\u8fd9\u4e9b\u5f02\u4f4d\u6548\u5e94\u80cc\u540e\u7684\u514d\u75ab\u5b66\u673a\u5236\uff0c\u5e76\u6982\u8ff0\u653e\u5c04\u6cbb\u7597\u4e0e\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u53ca\u5176\u4ed6\u514d\u75ab\u7597\u6cd5\u7684\u534f\u540c\u4f5c\u7528\u3002\u6700\u540e\uff0c\u6211\u4eec\u5c06\u63a2\u8ba8\u63a8\u52a8\u8fd9\u4e00\u8de8\u5b66\u79d1\u9886\u57df\u53d1\u5c55\u7684\u73b0\u6709\u969c\u788d\u548c\u673a\u9047\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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30.2  \u653e\u5c04\u6cbb\u7597\u76ee\u524d\u7684\u4e34\u5e8a\u4f7f\u7528\u548c\u5c40\u90e8\u5f71\u54cd<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4ece\u5386\u53f2\u4e0a\u770b\uff0c\u653e\u5c04\u80bf\u7624\u5b66\u9886\u57df\u662f\u5728\u4e0e\u6839\u9664\u80bf\u7624\u7ec6\u80de\u653e\u5c04\u6cbb\u7597\u662f\u57fa\u4e8e\u653e\u5c04\u751f\u7269\u5b66\u539f\u7406\u53d1\u5c55\u800c\u6765\uff0c\u65e8\u5728\u7cbe\u786e\u6d88\u9664\u80bf\u7624\u7ec6\u80de\u3002\u8fd9\u79cd\u65b9\u6cd5\u4f9d\u8d56\u4e8e\u80bf\u7624\u7ec6\u80de\u4fee\u590dDNA\u635f\u4f24\u80fd\u529b\u7684\u964d\u4f4e\uff0c\u6cbb\u7597\u7b56\u7565\u4e3b\u8981\u57fa\u4e8e\u4f53\u5916\u6a21\u578b\uff0c\u5373\u901a\u8fc7\u7ec6\u80de\u5b58\u6d3b\u66f2\u7ebf\u6765\u9884\u6d4b\u6cbb\u7597\u6548\u679c\u3002\u4f20\u7edf\u7684\u4e34\u5e8a\u524d\u6a21\u578b\u548c\u4e34\u5e8a\u7ecf\u9a8c\u63d0\u4f9b\u4e86\u5173\u4e8e\u5982\u4f55\u4fdd\u62a4\u90bb\u8fd1\u91cd\u8981\u7ed3\u6784\u7684\u91cd\u8981\u6307\u5bfc\uff0c\u8fd9\u4fc3\u6210\u4e86\u6bcf\u5929\u4f7f\u75281.8\u81f32.0\u6208\u745e\uff08Gy\uff09\u5242\u91cf\u7684\u5e7f\u6cdb\u5e94\u7528\uff0c\u6b64\u6cd5\u65e8\u5728\u51cf\u8f7b\u6bd2\u6027\uff0c\u4e3a\u6b63\u5e38\u7ec4\u7ec7\u4fee\u590dDNA\u635f\u4f24\u63d0\u4f9b\u65f6\u95f4\u3002\u7531\u4e8e\u65e5\u5242\u91cf\u8f83\u4f4e\uff0c\u4f20\u7edf\u6cbb\u7597\u9700\u89815\u81f37\u5468\u6765\u8fbe\u5230\u8db3\u591f\u7684\u7d2f\u79ef\u5242\u91cf\u4ee5\u6d88\u706d\u80bf\u7624\u7ec6\u80de\u3002\u8fd9\u79cd\u5ef6\u957f\u7597\u7a0b\u7684\u65b9\u6cd5\u4ecd\u662f\u6cbb\u7597\u4e73\u817a\u764c\u3001\u524d\u5217\u817a\u764c\u3001\u76f4\u80a0\u764c\u3001\u80f0\u817a\u764c\u3001\u8111\u764c\u548c\u5934\u9888\u764c\u7684\u6807\u51c6\u65b9\u6848\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e3a\u4e86\u5e94\u5bf9\u6bcf\u79cd\u75be\u75c5\u7684\u6269\u6563\u6a21\u5f0f\u548c\u590d\u53d1\u6a21\u5f0f\uff0c\u653e\u5c04\u6cbb\u7597\u4e2d\u5f15\u5165\u4e86\u201c\u4e34\u5e8a\u76ee\u6807\u4f53\u79ef\u201d(CTV)\u7684\u6982\u5ff5\u3002CTV\u4e0d\u4ec5\u5305\u62ec\u76f4\u63a5\u53ef\u89c1\u7684\u80bf\u7624\uff08\u5373\u603b\u80bf\u7624\u4f53\u79ef\u6216GTV\uff09\uff0c\u8fd8\u5305\u62ec\u80bf\u7624\u5468\u56f4\u53ef\u80fd\u5b58\u5728\u80bf\u7624\u7ec6\u80de\u7684\u4e9a\u4e34\u5e8a\u533a\u57df\uff0c\u5305\u62ec\u533a\u57df\u6027\u5f15\u6d41\u6dcb\u5df4\u7ed3(Fig <\/span>30.1<\/span>)\u3002\u6cbb\u7597\u76ee\u6807\u662f\u6e05\u9664\u5c40\u90e8\u533a\u57df\u5185\u6240\u6709\u80bf\u7624\u7ec6\u80de\uff0c\u9632\u6b62\u590d\u53d1\u5e76\u5c3d\u91cf\u51cf\u5c11\u8fdc\u5904\u6269\u6563\u3002\u5728CTV\u7684\u57fa\u7840\u4e0a\uff0c\u901a\u5e38\u8fd8\u4f1a\u6dfb\u52a0\u4e00\u4e2a\u989d\u5916\u7684\u8fb9\u754c\uff0c\u5f62\u6210\u201c\u8ba1\u5212\u76ee\u6807\u4f53\u79ef\u201d\u6216PTV\uff0c\u4ee5\u8003\u8651\u60a3\u8005\u4f53\u4f4d\u7684\u65e5\u5e38\u53d8\u52a8\u3002\u4f7f\u7528\u8f83\u65e7\u7684\u6210\u50cf\u6280\u672f\uff0c\u5904\u7406\u7684\u533a\u57df\u5f80\u5f80\u8f83\u5927\uff0c\u867d\u7136\u65e5\u5242\u91cf\u8f83\u4f4e\uff0c\u4f46\u53ef\u80fd\u5f15\u53d1\u663e\u8457\u7684\u526f\u4f5c\u7528\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7136\u800c\uff0c\u968f\u7740\u5f3a\u5ea6\u8c03\u5236\u653e\u5c04\u6cbb\u7597\uff08IMRT\uff09\u7684\u53d1\u5c55\u548c\u5e7f\u6cdb\u5e94\u7528\uff0c\u73b0\u5728\u53ef\u4ee5\u66f4\u7cbe\u786e\u5730\u63a7\u5236\u5242\u91cf\u5206\u5e03\uff0c\u66f4\u597d\u5730\u4fdd\u62a4\u90bb\u8fd1\u7684\u6b63\u5e38\u7ec4\u7ec7\u3002\u540c\u65f6\uff0c\u56fe\u50cf\u5f15\u5bfc\u653e\u5c04\u6cbb\u7597\uff08IGRT\uff09\uff0c\u5305\u62ec\u6cbb\u7597\u671f\u95f4\u7684\u65e5\u5e38CT\u626b\u63cf\uff0c\u5927\u5927\u63d0\u9ad8\u4e86\u5bf9\u6cbb\u7597\u76ee\u6807\u7684\u7cbe\u786e\u6027\u548c\u5bf9\u6b63\u5e38\u7ec4\u7ec7\u4f53\u79ef\u7684\u7ba1\u7406\uff0c\u4ece\u800c\u51cf\u5c11\u4e86\u526f\u4f5c\u7528\u3002\u5c3d\u7ba1CTV\u7684\u5b9a\u4e49\u901a\u5e38\u4fdd\u6301\u4e0d\u53d8\uff0c\u4f46\u73b0\u4ee3\u6280\u672f\u7684\u8fdb\u6b65\u4f7f\u5f97\u8bbe\u5907\u80fd\u591f\u66f4\u6709\u6548\u5730\u63a7\u5236CTV\u5728\u6cbb\u7597\u671f\u95f4\u7684\u751f\u7406\u8fd0\u52a8\uff0c\u4ece\u800c\u63d0\u9ad8\u6cbb\u7597\u7684\u7cbe\u786e\u5ea6\u548c\u6548\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig <\/span>30.1 <\/span>\u63cf\u8ff0\u4e86\u653e\u5c04\u6cbb\u7597\u4e2d\u4f7f\u7528\u7684\u5404\u79cd\u6cbb\u7597\u8fb9\u754c\u3002\u5176\u4e2d\uff0c\u201cGTV\u201d\u4ee3\u8868\u80bf\u7624\u603b\u4f53\u79ef\uff0c\u5373\u76f4\u63a5\u53ef\u89c1\u6216\u5df2\u8bca\u65ad\u51fa\u7684\u80bf\u7624\u533a\u57df\u3002\u201cCTV\u201d\u6307\u7684\u662f\u4e34\u5e8a\u9776\u4f53\u79ef\uff0c\u8fd9\u4e0d\u4ec5\u5305\u62ecGTV\uff0c\u8fd8\u5305\u62ec\u5468\u56f4\u53ef\u80fd\u6f5c\u85cf\u5fae\u5c0f\u80bf\u7624\u7ec6\u80de\u7684\u533a\u57df\uff0c\u4ee5\u53ca\u76f8\u5173\u7684\u533a\u57df\u6027\u6dcb\u5df4\u7ed3\u3002\u201cPTV\u201d\u5219\u662f\u89c4\u5212\u9776\u4f53\u79ef\uff0c\u5b83\u5728CTV\u7684\u57fa\u7840\u4e0a\u989d\u5916\u6269\u5c55\u4e00\u5b9a\u8fb9\u754c\uff0c\u4ee5\u8003\u8651\u5230\u65e5\u5e38\u6cbb\u7597\u4e2d\u53ef\u80fd\u51fa\u73b0\u7684\u60a3\u8005\u4f53\u4f4d\u53d8\u52a8\u548c\u5176\u4ed6\u6280\u672f\u56e0\u7d20\u7684\u5f71\u54cd\uff0c\u786e\u4fdd\u6574\u4e2a\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u80bf\u7624\u533a\u57df\u5f97\u5230\u6709\u6548\u7167\u5c04\u3002\u8fd9\u4e9b\u5b9a\u4e49\u5e2e\u52a9\u653e\u5c04\u6cbb\u7597\u56e2\u961f\u7cbe\u786e\u5b9a\u4f4d\u6cbb\u7597\u533a\u57df\uff0c\u4f18\u5316\u6cbb\u7597\u6548\u679c\uff0c\u540c\u65f6\u5c3d\u91cf\u51cf\u5c11\u5bf9\u5065\u5eb7\u7ec4\u7ec7\u7684\u635f\u4f24\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u9664\u4e86\u7f29\u77ed\u6cbb\u7597\u5468\u671f\uff0c\u6cbb\u7597\u8f6c\u79fb\u7624\u65f6\u8fd8\u7ecf\u5e38\u8c03\u6574\u6216\u6d88\u9664CTV\u8fb9\u7f18\u3002\u6539\u8fdb\u7684\u56fa\u5b9a\u548c\u6210\u50cf\u6280\u672f\u786e\u4fdd\u4e86\u76ee\u6807\u533a\u57df\u7684\u5145\u5206\u8986\u76d6\uff0c\u5176\u7cbe\u786e\u5ea6\u53ef\u4e0e\u624b\u672f\u76f8\u5339\u914d\uff0c\u540c\u65f6\u663e\u8457\u51cf\u5c11\u4e86\u6b63\u5e38\u7ec4\u7ec7\u7684\u53d7\u5f71\u54cd\u8303\u56f4\u3002\u73b0\u5728\u53ef\u4ee5\u5b89\u5168\u5730\u5b9e\u65bd6\u81f330 Gy\u6216\u66f4\u9ad8\u5242\u91cf\u7684\u6cbb\u7597\uff0c\u52061\u81f35\u6b21\u7ed9\u836f\uff0c\u8fd9\u79cd\u65b9\u6cd5\u88ab\u5b9a\u4e49\u4e3a\u7acb\u4f53\u5b9a\u5411\u653e\u5c04\u6cbb\u7597\uff08\u5305\u62ec\u7acb\u4f53\u5b9a\u5411\u653e\u5c04\u5916\u79d1\u6216SRS\u3001\u7acb\u4f53\u5b9a\u5411\u4f53\u653e\u5c04\u6cbb\u7597\u6216SBRT\u3001\u7acb\u4f53\u5b9a\u5411\u6d88\u878d\u653e\u5c04\u6cbb\u7597\u6216SABR\uff09\u3002\u6cbb\u7597\u671f\u95f4\uff0c\u60a3\u8005\u88ab\u7cbe\u786e\u56fa\u5b9a\u5e76\u8fdb\u884c\u6210\u50cf\uff0c\u786e\u4fdd\u6cbb\u7597\u7cbe\u786e\u65e0\u8bef\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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RTOG 90-05\u8bd5\u9a8c\u5219\u63a2\u8ba8\u4e86\u5355\u6b21\u5242\u91cf\u7acb\u4f53\u5b9a\u5411\u6cbb\u7597\u8111\u8f6c\u79fb\u7624\u7684\u6548\u679c\uff0c\u8fd9\u662f\u4e00\u9879\u6839\u636e\u8111\u8f6c\u79fb\u7624\u5927\u5c0f\u9010\u6e10\u589e\u52a0\u5242\u91cf\u7684\u8bd5\u9a8c\u3002\u867d\u7136\u5bf9\u5c0f\u75c5\u53d8\uff08\u5c0f\u4e8e2\u5398\u7c73\uff09\u7684\u9ad8\u5242\u91cf\u6cbb\u7597\u6bd2\u6027\u6700\u5c0f\uff0c\u4f46\u5bf9\u8f83\u5927\u75c5\u53d8\u7684\u6cbb\u7597\u53ef\u80fd\u5bfc\u81f4\u4e25\u91cd\u7684\u795e\u7ecf\u6bd2\u6027\uff0c\u5982\u653e\u5c04\u6027\u574f\u6b7b\uff08\u8f90\u5c04\u5bfc\u81f4\u7684\u8111\u7ec4\u7ec7\u574f\u6b7b\uff09\u3002\u56e0\u6b64\uff0c\u9ad8\u5242\u91cf\u7684\u5355\u6b21\u6cbb\u7597\u9700\u8c28\u614e\u8fdb\u884c\uff0c\u8bb8\u591a\u4e2d\u5fc3\u4f1a\u5c06\u5355\u6b21\u5242\u91cf\u5206\u4e3a3\u81f35\u6b21\u7ed9\u836f\uff0c\u4ee5\u51cf\u5c11\u5bf9\u8f83\u5927\u80bf\u7624\u7684\u6bd2\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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30.3 \u4ece\u5c40\u90e8\u5230\u8fdc\u7aef\uff1a\u653e\u7597\u4e0e\u5168\u8eab\u80bf\u7624\u63a7\u5236<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u653e\u5c04\u6cbb\u7597\u7684\u7ec6\u80de\u6bd2\u6027\u4f5c\u7528\u901a\u5e38\u5c40\u9650\u4e8e\u76f4\u63a5\u8f90\u5c04\u533a\u57df\uff0c\u4f46\u6709\u65f6\u4e5f\u4f1a\u5728\u8f90\u5c04\u533a\u57df\u5916\u89c2\u5bdf\u5230\u8fdc\u5904\u80bf\u7624\u7684\u6d88\u9000\uff0c\u8fd9\u79cd\u73b0\u8c61\u6700\u65e9\u7531Mole\u57281953\u5e74\u5b9a\u4e49\u4e3a\u201c\u8fdc\u9694\u6548\u5e94\u201d\uff08\u5e7f\u6cdb\u7684\u3001\u9776\u5916\u6548\u5e94\uff09\u3002\u8fdc\u9694\u6548\u5e94\u867d\u7136\u5728\u591a\u79cd\u6076\u6027\u80bf\u7624\u4e2d\u6709\u62a5\u9053\uff0c\u4f46\u5728\u4f20\u7edf\u653e\u7597\u4e2d\u76f8\u5bf9\u7f55\u89c1\u3002\u7136\u800c\uff0c\u6709\u8da3\u7684\u662f\uff0c\u5728\u4f7f\u7528\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6cbb\u7597\u8fdb\u5c55\u671f\u9ed1\u8272\u7d20\u7624\u7684\u60a3\u8005\u4e2d\uff0c\u653e\u7597\u4e0e\u514d\u75ab\u6cbb\u7597\u7684\u7ed3\u5408\u663e\u8457\u589e\u52a0\u4e86\u8fdc\u9694\u6548\u5e94\u7684\u53d1\u751f\u7387\u3002\u8fd9\u4e9b\u4e34\u5e8a\u89c2\u5bdf\u548c\u5b9e\u9a8c\u5ba4\u8bc1\u636e\u5171\u540c\u6307\u5411\u4e86T\u7ec6\u80de\u4ecb\u5bfc\u7684\u53cd\u5e94\u673a\u5236\uff0c\u6fc0\u53d1\u4e86\u5bf9\u653e\u5c04\u6cbb\u7597\u5728\u589e\u5f3a\u514d\u75ab\u6cbb\u7597\u6548\u679c\u65b9\u9762\u7684\u7814\u7a76\u5174\u8da3\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6b64\u5916\uff0c\u65e0\u8bba\u662f\u5355\u72ec\u653e\u7597\u8fd8\u662f\u4e0e\u4e0d\u540c\u7684\u514d\u75ab\u8c03\u8282\u5242\u8054\u5408\u4f7f\u7528\uff0c\u5f02\u4f4d\u53cd\u5e94\u4e5f\u5728\u591a\u79cd\u5176\u4ed6\u6076\u6027\u80bf\u7624\u4e2d\u88ab\u8bb0\u5f55\u3002\u7efc\u5408\u6765\u770b\uff0c\u8fd9\u4e9b\u6570\u636e\u8868\u660e\uff0c\u5728\u4e0d\u540c\u7c7b\u578b\u7684\u80bf\u7624\u4e2d\uff0c\u653e\u5c04\u6cbb\u7597\u80fd\u591f\u5f15\u53d1\u8fdc\u9694\u6548\u5e94\u3002\u7136\u800c\uff0c\u76ee\u524d\u5c1a\u4e0d\u6e05\u695a\u662f\u5426\u9700\u8981\u4e00\u5b9a\u7a0b\u5ea6\u7684\u9884\u5148\u5b58\u5728\u7684\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u4f5c\u4e3a\u524d\u63d0\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4f8b\u5982\uff0c\u9488\u5bf9\u4e0d\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u4ea7\u751f\u53cd\u5e94\u7684\u4e73\u817a\u764c\u548c\u5927\u80a0\u764c\u7684\u5c0f\u9f20\u6a21\u578b\u7684\u7814\u7a76\u8868\u660e\uff0c\u4ec5\u5f53\u653e\u7597\u88ab\u7eb3\u5165\u6cbb\u7597\u65b9\u6848\u65f6\uff0c\u624d\u80fd\u89c2\u5bdf\u5230\u5f02\u4f4d\u53cd\u5e94\u3002\u8fd9\u7a81\u663e\u4e86\u653e\u7597\u65b9\u6848\u7684\u5173\u952e\u6027\uff1a\u4f8b\u5982\uff0c\u9488\u5bf9CTLA-4\u7684\u6297\u4f53\uff0c\u5355\u6b21\u5242\u91cf20 Gy\u8868\u73b0\u65e0\u6548\uff0c\u800c\u8fde\u7eed\u51e0\u5929\u5206\u522b\u7ed9\u4e886 Gy x 5\u548c8 Gy x 3\u7684\u65b9\u6848\uff0c\u5219\u80fd\u5b9e\u73b0\u5b8c\u5168\u6216\u90e8\u5206\u7684\u5f02\u4f4d\u53cd\u5e94\u3002\u867d\u7136\u5728\u4e34\u5e8a\u4e0a\u8fd8\u672a\u786e\u5b9a\u4e0e\u514d\u75ab\u6cbb\u7597\u7ed3\u5408\u4f7f\u7528\u7684\u6700\u4f73\u653e\u7597\u65b9\u6848\uff0c\u4f46\u6709\u8da3\u7684\u662f\uff0c\u81f3\u5c11\u5728\u4e0e\u6297CTLA-4\u6297\u4f53\u7ed3\u5408\u65f6\uff0c\u7c7b\u4f3c\u4e8e\u5728\u5c0f\u9f20\u4e2d\u6709\u6548\u7684\u653e\u7597\u65b9\u6848\u540c\u6837\u80fd\u5728\u4eba\u4f53\u4e2d\u8bf1\u53d1\u5f02\u4f4d\u53cd\u5e94\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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30.4 \u589e\u5f3a\u5c40\u90e8\u63a7\u5236\uff1a\u4fc3\u8fdb\u6297\u80bf\u7624\u514d\u75ab\u5e94\u7b54\u6548\u5e94\u9636\u6bb5\u7684\u653e\u5c04\u6cbb\u7597\u6548\u679c<\/strong><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7814\u7a76\u89c2\u5bdf\u5230\uff0c\u5728\u7f3a\u4e4f\u6b63\u5e38T\u7ec6\u80de\u5ba4\u7684\u5c0f\u9f20\u4e2d\uff0c\u76f8\u8f83\u4e8e\u514d\u75ab\u6b63\u5e38\u7684\u5c0f\u9f20\uff0c\u6cbb\u6108\u7ecf\u8f90\u5c04\u7684\u80bf\u7624\u9700\u8981\u66f4\u9ad8\u5242\u91cf\u7684\u8f90\u5c04\u3002\u8fd9\u4e00\u53d1\u73b0\u9996\u6b21\u6307\u51fa\u4e86T\u7ec6\u80de\u5bf9\u653e\u5c04\u6cbb\u7597\u5c40\u90e8\u53cd\u5e94\u7684\u91cd\u8981\u6027\uff0c\u5e76\u572830\u5e74\u540e\u901a\u8fc7\u4f7f\u7528\u643a\u5e26\u6a21\u578b\u6297\u539f\u7684\u5c0f\u9f20\u80bf\u7624\u5b9e\u9a8c\u5f97\u5230\u8bc1\u5b9e\u3002\u7136\u800c\uff0cT\u7ec6\u80de\u5728\u4fc3\u8fdb\u60a3\u8005\u653e\u5c04\u6cbb\u7597\u5c40\u90e8\u53cd\u5e94\u4e2d\u7684\u5177\u4f53\u4f5c\u7528\u4ecd\u9700\u8fdb\u4e00\u6b65\u7814\u7a76\u3002\u5c3d\u7ba1\u5982\u5375\u6e05\u86cb\u767d\u7b49\u6a21\u578b\u6297\u539f\u4fbf\u4e8e\u8fdb\u884c\u539f\u7406\u9a8c\u8bc1\u7814\u7a76\uff0c\u5b83\u4eec\u7684\u9ad8\u514d\u75ab\u539f\u6027\u548c\u8868\u8fbe\u6c34\u5e73\u5e76\u4e0d\u771f\u5b9e\u53cd\u6620\u764c\u75c7\u60a3\u8005\u7684\u60c5\u51b5\uff0c\u56e0\u4e3a\u80bf\u7624\u7ec6\u80de\u5df2\u7ecf\u9010\u6e10\u8fdb\u5316\u51fa\u9003\u907f\u514d\u75ab\u7cfb\u7edf\u7684\u7b56\u7565\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6b64\u5916\uff0c\u653e\u5c04\u6cbb\u7597\u8fd8\u53ef\u80fd\u89e6\u53d1\u514d\u75ab\u6291\u5236\u4fe1\u53f7\u3002\u4f8b\u5982\uff0c\u5728\u4e24\u4e2a\u514d\u75ab\u539f\u6027\u8f83\u4f4e\u7684\u5c0f\u9f20\u764c\u75c7\u6a21\u578b\u4e2d\uff0c\u4ec5\u5728\u4e2d\u548c\u4e86\u653e\u5c04\u6fc0\u6d3b\u7684\u5f3a\u514d\u75ab\u6291\u5236\u56e0\u5b50TGF-\u03b2\u540e\uff0cCD8+ <\/sup>T\u7ec6\u80de\u5bf9\u4e09\u79cd\u5185\u6e90\u6027\u6297\u539f\u7684\u53cd\u5e94\u624d\u663e\u73b0\u3002\u5728\u4e34\u5e8a\u4e0a\uff0c\u5c11\u6709\u8bc1\u636e\u8868\u660e\u4ec5\u901a\u8fc7\u6807\u51c6\u653e\u7597\u80fd\u591f\u6fc0\u6d3b\u80bf\u7624\u7279\u5f02\u6027T\u7ec6\u80de\u3002\u56e0\u6b64\uff0c\u653e\u5c04\u6cbb\u7597\u5bf9T\u7ec6\u80de\u7684\u6fc0\u6d3b\u4f5c\u7528\u53ef\u80fd\u4e3b\u8981\u5728\u4e0e\u514d\u75ab\u6cbb\u7597\u7ed3\u5408\u4f7f\u7528\u65f6\u624d\u663e\u73b0\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u5728\u5df2\u6709\u6297\u80bf\u7624T\u7ec6\u80de\u53cd\u5e94\u7684\u60a3\u8005\u4e2d\uff0c\u653e\u7597\u80fd\u591f\u91cd\u65b0\u6fc0\u6d3b\u505c\u6ede\u7684\u514d\u75ab\u53cd\u5e94\uff0c\u8fd9\u662f\u901a\u8fc7\u5bf9\u6297\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u7684T\u7ec6\u80de\u6392\u65a5\u4ee5\u53ca\u764c\u7ec6\u80de\u7531\u4e8e\u4e3b\u8981\u7ec4\u7ec7\u76f8\u5bb9\u6027\u590d\u5408\u4f53I\u7c7b\uff08MHC-I\uff09\u6297\u539f\u63d0\u5448\u5206\u5b50\u4e0b\u8c03\u800c\u5bfc\u81f4\u7684\u6297\u539f\u6027\u964d\u4f4e\u8fd9\u4e24\u4e2a\u5173\u952e\u514d\u75ab\u9003\u9038\u673a\u5236\u5b9e\u73b0\u7684(Fig 30.2<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig<\/span>30.2<\/span> \u4fc3\u8fdb\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u6548\u5e94\u671f\u7684\u653e\u5c04\u6cbb\u7597\u6548\u5e94\u3002\u5de6\uff0c\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de(CTL)\u5b58\u5728\uff0c\u4f46\u7531\u4e8e\u8840\u7ba1\u5c4f\u969c\u7684\u5b58\u5728\u800c\u65e0\u6cd5\u8fdb\u5165\u80bf\u7624\uff0c\u8fd9\u662f\u7531\u4fc3\u8840\u7ba1\u751f\u6210\u80bf\u7624\u76f8\u5173\u5de8\u566c\u7ec6\u80de(TAM)\u4fc3\u8fdb\u7684\u3002\u6b64\u5916\uff0cMHC-I\u5728\u764c\u7ec6\u80de\u4e0a\u7684\u4e0b\u8c03\u4e5f\u963b\u6b62\u4e86\u5b83\u4eec\u88abCTL\u8bc6\u522b\u3002\u6b63\u56e0\u5982\u6b64\uff0c\u653e\u5c04\u6cbb\u7597\u91cd\u7ec4\u5de8\u566c\u7ec6\u80de\u5bfc\u81f4\u8840\u7ba1\u6b63\u5e38\u5316\uff0c\u4ece\u800c\u5141\u8bb8\u80bf\u7624\u88abCTL\u6d78\u6da6\u3002\u6b64\u5916\uff0c\u8f90\u5c04\u53ef\u4e0a\u8c03\u764c\u7ec6\u80de\u4e0a\u7684MHC-I\u3001NKD2D\u914d\u4f53\u548cFas\uff0c\u4f7f\u5b83\u4eec\u6210\u4e3aCTLs\u8bc6\u522b\u548c\u6d88\u9664\u7684\u826f\u597d\u9776\u70b9\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8f90\u5c04\u6cbb\u7597\u80fd\u591f\u5f15\u8d77\u4e00\u7cfb\u5217\u514d\u75ab\u8c03\u8282\u53d8\u5316\uff0c\u5305\u62ec\u91ca\u653e\u8d8b\u5316\u56e0\u5b50\uff0c\u8fd9\u4e9b\u56e0\u5b50\u5438\u5f15\u6548\u5e94T\u7ec6\u80de\u8fdb\u5165\u80bf\u7624\uff0c\u5e76\u589e\u52a0\u8840\u7ba1\u5185\u76ae\u7ec6\u80de\u4e0a\u7684\u7c98\u9644\u5206\u5b50\u8868\u8fbe\uff0c\u4ece\u800c\u4fc3\u8fdbT\u7ec6\u80de\u7684\u6d78\u6da6\uff0c\u5982\u5728\u5c0f\u9f20\u4e73\u817a\u764c\u548c\u9ed1\u8272\u7d20\u7624\u6a21\u578b\u4e2d\u6240\u793a\u3002\u6b64\u5916\uff0c\u7814\u7a76\u8fd8\u53d1\u73b0\u653e\u5c04\u6cbb\u7597\u53ef\u4ee5\u91cd\u65b0\u7f16\u7a0b\u80bf\u7624\u76f8\u5173\u7684\u5de8\u566c\u7ec6\u80de\uff08TAM\uff09\uff0c\u5e76\u4e0e\u8fc7\u7ee7T\u7ec6\u80de\u8f6c\u79fb\u534f\u4f5c\uff0c\u901a\u8fc7\u4fc3\u8fdb\u8840\u7ba1\u6b63\u5e38\u5316\u6765\u5f3a\u5316\u80f0\u817a\u80bf\u7624\u7684\u514d\u75ab\u6392\u65a5\u53cd\u5e94\u3002\u6709\u8da3\u7684\u662f\uff0c\u8111\u80f6\u8d28\u7624\u539f\u4f4d\u5c0f\u9f20\u6a21\u578b\u4e2d\u4e5f\u89c2\u5bdf\u5230\u5916\u5468\u75ab\u82d7\u6fc0\u6d3b\u7684T\u7ec6\u80de\u589e\u52a0\u4e86\u5bf9\u8f90\u7167\u80bf\u7624\u7684\u6d78\u6da6\uff0c\u8868\u660e\u8fd9\u4e00\u673a\u5236\u9002\u7528\u4e8e\u751f\u957f\u5728\u4e0d\u540c\u89e3\u5256\u4f4d\u7f6e\u7684\u591a\u79cd\u5b9e\u4f53\u80bf\u7624\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u4f53\u5916\u548c\u4f53\u5185\u5b9e\u9a8c\u4e2d\uff0c\u591a\u79cd\u5c0f\u9f20\u548c\u4eba\u7c7b\u764c\u7ec6\u80de\u6a21\u578b\u5747\u663e\u793a\u8f90\u5c04\u80fd\u591f\u4e0a\u8c03MHC-I\u7684\u8868\u8fbe\u3002\u4f53\u5916\u5b9e\u9a8c\u4e2d\uff0cMHC-I\u7684\u589e\u52a0\u80fd\u591f\u589e\u5f3aCD8+<\/sup>\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de\uff08CTL\uff09\u5bf9\u8f90\u5c04\u540e\u764c\u7ec6\u80de\u7684\u6eb6\u89e3\u80fd\u529b\uff1b\u5728\u4f53\u5185\uff0c\u5b83\u5219\u63d0\u9ad8\u4e86\u8fc7\u7ee7\u8f6c\u79fb\u548c\u75ab\u82d7\u6fc0\u6d3bT\u7ec6\u80de\u4ecb\u5bfc\u7684\u80bf\u7624\u6392\u65a5\u53cd\u5e94\u3002\u9664\u4e86\u63d0\u9ad8\u764c\u7ec6\u80de\u7684\u6297\u539f\u6027\uff0c\u8f90\u5c04\u8fd8\u88ab\u53d1\u73b0\u80fd\u589e\u52a0\u5e94\u6fc0\u8bf1\u5bfc\u914d\u4f53\u7684\u8868\u8fbe\uff0c\u8fd9\u4e9b\u914d\u4f53\u53ef\u4e0eCTL\u548c\u81ea\u7136\u6740\u4f24\u7ec6\u80de\uff08NK\uff09\u8868\u9762\u7684NKG2D\u53d7\u4f53\u7ed3\u5408\uff0c\u4ece\u800c\u4fc3\u8fdb\u8fd9\u4e9b\u514d\u75ab\u7ec6\u80de\u5bf9\u764c\u7ec6\u80de\u7684\u6740\u4f24\u4f5c\u7528\u3002\u8f90\u5c04\u8fd8\u901a\u8fc7\u8bf1\u5bfc\u6b7b\u4ea1\u53d7\u4f53Fas\/CD95\u7684\u8868\u8fbe\uff0c\u589e\u5f3aT\u7ec6\u80de\u6740\u4f24\u764c\u7ec6\u80de\u7684\u80fd\u529b\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u56e0\u6b64\uff0c\u653e\u5c04\u6cbb\u7597\u901a\u8fc7\u5bf9\u764c\u7ec6\u80de\u548c\u80bf\u7624\u5fae\u73af\u5883\u7684\u591a\u91cd\u4f5c\u7528\uff0c\u663e\u8457\u589e\u5f3a\u4e86\u514d\u75ab\u4ecb\u5bfc\u7684\u80bf\u7624\u6392\u65a5\u53cd\u5e94\u3002\u5982\u679c\u60a3\u8005\u4f53\u5185\u9884\u5148\u5b58\u5728\u6297\u80bf\u7624T\u7ec6\u80de\uff0c\u90a3\u4e48\u9002\u5e94\u6027\u514d\u75ab\u53ef\u80fd\u6709\u52a9\u4e8e\u901a\u8fc7\u653e\u7597\u5b9e\u73b0\u5c40\u90e8\u80bf\u7624\u63a7\u5236\u3002\u6b64\u5916\uff0c\u4e34\u5e8a\u524d\u7814\u7a76\u663e\u793a\uff0c\u9488\u5bf9\u80bf\u7624\u7684\u653e\u5c04\u6cbb\u7597\u53ef\u4ee5\u4f7f\u8010\u836f\u8f6c\u79fb\u80bf\u7624\u5bf9\u8fc7\u7ee7T\u7ec6\u80de\u53d8\u5f97\u654f\u611f\u3002\u653e\u5c04\u6cbb\u7597\u8fd8\u53ef\u80fd\u6062\u590d\u80bf\u7624\u5bf9\u6fc0\u6d3b\u5185\u6e90\u6027\u6297\u80bf\u7624T\u7ec6\u80de\u7684\u5176\u4ed6\u514d\u75ab\u7597\u6cd5\u7684\u53cd\u5e94\u3002\u80bf\u7624\u4e2dMHC-I\u7684\u4e0b\u8c03\u662f\u591a\u79cd\u514d\u75ab\u7597\u6cd5\uff08\u5305\u62ecPD-1\u963b\u65ad\uff09\u8010\u836f\u7684\u673a\u5236\u4e4b\u4e00\uff0c\u6700\u8fd1\u5728PD-1\u8010\u836f\u7684\u80ba\u764c\u5c0f\u9f20\u6a21\u578b\u4e2d\u7684\u7814\u7a76\u8868\u660e\uff0c\u653e\u5c04\u8bf1\u5bfc\u7684MHC-I\u5206\u5b50\u7684\u4e0a\u8c03\u53ef\u4ee5\u5728\u67d0\u4e9b\u60c5\u51b5\u4e0b\u514b\u670d\u5bf9\u6297PD-1\u6cbb\u7597\u7684\u8010\u836f\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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30.5 \u8bf1\u5bfc\u8fdc\u9694\u6548\u5e94\uff1a\u653e\u5c04\u6cbb\u7597\u4fc3\u8fdb\u6297\u80bf\u7624T\u7ec6\u80de\u542f\u52a8\u7684\u6548\u679c<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u81ea\u7136\u60c5\u51b5\u4e0b\u65e0\u6cd5\u6709\u6548\u751f\u6210\u6297\u80bf\u7624T\u7ec6\u80de\u7684\u60a3\u8005\u4e2d\u5b9e\u73b0\u8fd9\u4e00\u70b9\uff0c\u4ecd\u7136\u662f\u764c\u75c7\u514d\u75ab\u6cbb\u7597\u9762\u4e34\u7684\u4e00\u5927\u6311\u6218\u3002\u5c3d\u7ba1\u5728\u764c\u75c7\u53d1\u5c55\u8fc7\u7a0b\u4e2d\uff0c\u514d\u75ab\u7cfb\u7edf\u53ef\u80fd\u4f1a\u8bc6\u522b\u6240\u6709\u7c7b\u578b\u7684\u764c\u7ec6\u80de\uff0c\u4f46\u5927\u591a\u6570\u4e34\u5e8a\u4e0a\u53ef\u68c0\u6d4b\u7684\u80bf\u7624\u90fd\u80fd\u901a\u8fc7\u7f16\u8f91T\u7ec6\u80de\u8bc6\u522b\u7684\u6297\u539f\u6765\u9003\u907f\u514d\u75ab\u76d1\u89c6\u3002\u7136\u800c\uff0c\u80bf\u7624\u7684\u56fa\u6709\u9057\u4f20\u4e0d\u7a33\u5b9a\u6027\u4f1a\u5bfc\u81f4\u66f4\u591a\u7684\u7a81\u53d8\uff0c\u8fd9\u4e9b\u7a81\u53d8\u5f80\u5f80\u5177\u6709\u6297\u539f\u6027\uff0c\u6210\u4e3a\u5f3a\u6548\u6297\u80bf\u7624\u53cd\u5e94\u7684\u9776\u6807\u3002\u4e0e\u6b64\u540c\u65f6\uff0c\u6297\u80bf\u7624T\u7ec6\u80de\u53d1\u80b2\u7684\u4e00\u4e2a\u4e3b\u8981\u969c\u788d\u662f\u6811\u7a81\u72b6\u7ec6\u80de\u7684\u529f\u80fd\u969c\u788d\u548c\u6570\u91cf\u4e0d\u8db3\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u653e\u5c04\u6cbb\u7597\u81f3\u5c11\u90e8\u5206\u5730\u80fd\u591f\u514b\u670d\u542f\u52a8\u6297\u80bf\u7624T\u7ec6\u80de\u7684\u8fd9\u4e9b\u969c\u788d(Fig 30.3<\/span>)\u3002\u5728\u5b9e\u9a8c\u6a21\u578b\u4e2d\uff0c\u6709\u8bc1\u636e\u663e\u793a\u653e\u5c04\u6cbb\u7597\u589e\u52a0\u4e86\u6811\u7a81\u72b6\u7ec6\u80de\uff08DC\uff09\u5411\u80bf\u7624\u7684\u62db\u52df\u53ca\u6d3b\u5316\uff0c\u8fd9\u4e00\u8fc7\u7a0b\u662f\u7531\u8f90\u5c04\u8bf1\u5bfc\u7684\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\uff08ICD\uff09\u671f\u95f4\u91ca\u653e\u7684\u5371\u9669\u4fe1\u53f7\u6240\u4ecb\u5bfc\u3002ICD\u671f\u95f4\u5178\u578b\u7684\u5371\u9669\u4fe1\u53f7\u5305\u62ec\u9499\u7f51\u86cb\u767d\u8f6c\u79fb\u5230\u6b7b\u4ea1\u7ec6\u80de\u8868\u9762\uff0c\u4fc3\u8fdb\u5176\u88abDCs\u5438\u6536\uff1b\u9ad8\u8fc1\u79fb\u7387\u65cf\u86cb\u767d\u76d2-1\uff08HMGB-1\uff09\u7684\u91ca\u653e\u4e0eDCs\u4e0a\u7684Toll\u6837\u53d7\u4f534\uff08TLR4\uff09\u7684\u7ed3\u5408\uff1b\u4ee5\u53caATP\u7684\u91ca\u653e\u901a\u8fc7P2X7\u53d7\u4f53\u6fc0\u6d3b\u6811\u7a81\u72b6\u7ec6\u80de\u4e2d\u7684\u708e\u75c7\u5c0f\u4f53\u3002\u6b64\u5916\uff0c\u5f53\u8f90\u5c04\u540e\u7684\u764c\u7ec6\u80deDNA\u8fdb\u5165DCs\u7684\u7ec6\u80de\u8d28\u65f6\uff0c\u901a\u8fc7STING\uff08\u5e72\u6270\u7d20\u57fa\u56e0\u523a\u6fc0\u56e0\u5b50\uff09\u9014\u5f84\u6fc0\u6d3bI\u578b\u5e72\u6270\u7d20\u7684\u4ea7\u751f\uff0c\u4ece\u800c\u63d0\u4f9b\u4e86\u53e6\u4e00\u79cd\u81ea\u5206\u6ccc\u65b9\u5f0f\u6fc0\u6d3bDCs\u7684\u4fe1\u53f7\u3002\u8fd9\u4e9b\u673a\u5236\u5171\u540c\u63a8\u52a8\u4e86\u6297\u80bf\u7624T\u7ec6\u80de\u7684\u542f\u52a8\u548c\u529f\u80fd\uff0c\u4e3a\u514d\u75ab\u6cbb\u7597\u63d0\u4f9b\u4e86\u6709\u529b\u652f\u6301\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig<\/span>30.3<\/span> \u63cf\u8ff0\u4e86\u653e\u5c04\u6cbb\u7597\u5982\u4f55\u4fc3\u8fdb\u6297\u80bf\u7624T\u7ec6\u80de\u542f\u52a8\u7684\u6548\u5e94\u3002\u5728\u6b64\u8fc7\u7a0b\u4e2d\uff0c\u8f90\u5c04\u5904\u7406\u7684\u764c\u7ec6\u80de\u91ca\u653e\u5371\u9669\u4fe1\u53f7\uff0c\u8fd9\u4e9b\u4fe1\u53f7\u4fc3\u4f7f\u6811\u7a81\u7ec6\u80de\uff08DCs\uff09\u88ab\u62db\u52df\u81f3\u80bf\u7624\u90e8\u4f4d\u3002\u5728\u6b64\uff0c\u6811\u7a81\u7ec6\u80de\u5438\u6536\u5782\u6b7b\u7684\u764c\u7ec6\u80de\u5e76\u968f\u540e\u88ab\u6fc0\u6d3b\u3002\u6d3b\u5316\u7684\u6811\u7a81\u7ec6\u80de\u643a\u5e26\u80bf\u7624\u6297\u539f\u5230\u8fbe\u80bf\u7624\u5f15\u6d41\u6dcb\u5df4\u7ed3\uff08TDLN\uff09\uff0c\u5728\u90a3\u91cc\u5b83\u4eec\u542f\u52a8\u80bf\u7624\u7279\u5f02\u6027T\u7ec6\u80de\u7684\u4ea4\u53c9\u5448\u9012\u3002\u8fd9\u4e9b\u521d\u59cbT\u7ec6\u80de\u8fdb\u4e00\u6b65\u5206\u5316\u6210\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de\uff08CTLs\uff09\uff0c\u5e76\u8fc1\u79fb\u5230\u88ab\u8f90\u5c04\u5904\u7406\u7684\u80bf\u7624\uff08\u56fe\u4e2d\u53f3\u4fa7\uff09\u53ca\u672a\u53d7\u7167\u5c04\u7684\u8f6c\u79fb\u7076\uff08\u56fe\u4e2d\u5de6\u4fa7\uff09\uff0c\u5728\u8fd9\u4e9b\u90e8\u4f4d\u4ecb\u5bfc\u80bf\u7624\u7684\u5b8c\u5168\u6d88\u9000\u548c\u5f02\u4f4d\u53cd\u5e94\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e0a\u8ff0\u4fe1\u53f7\u7684\u4ea7\u751f\u4f9d\u8d56\u4e8e\u5e94\u6fc0\u53cd\u5e94\u901a\u8def\u7684\u6fc0\u6d3b\uff0c\u8fd9\u4e9b\u901a\u8def\u5305\u62ec\u672a\u6298\u53e0\u86cb\u767d\u53cd\u5e94\u548c\u81ea\u566c\uff0c\u5b83\u4eec\u5728\u764c\u7ec6\u80de\u56e0\u8f90\u5c04\u800c\u6b7b\u4ea1\u65f6\u88ab\u89e6\u53d1\u3002\u764c\u7ec6\u80de\u7684\u6b7b\u4ea1\u65b9\u5f0f\u591a\u79cd\u591a\u6837\uff0c\u5177\u4f53\u53d6\u51b3\u4e8e\u54ea\u79cd\u5b58\u6d3b\u6216\u51cb\u4ea1\u9014\u5f84\u88ab\u6fc0\u6d3b\uff0c\u4ee5\u53ca\u80bf\u7624\u5fae\u73af\u5883\u7684\u7c7b\u578b\u3001\u4f7f\u7528\u7684\u8f90\u5c04\u5242\u91cf\u548c\u5206\u7ea7\u65b9\u6cd5\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u6811\u7a81\u7ec6\u80de\uff08DCs\uff09\u7684\u6570\u91cf\u9650\u5236\u4e86\u8f90\u5c04\u5f15\u53d1\u7684\u6297\u80bf\u7624T\u7ec6\u80de\u53cd\u5e94\u7684\u89c4\u6a21\uff0c\u800c\u514d\u75ab\u6291\u5236\u673a\u5236\u7684\u5b58\u5728\u5219\u8fdb\u4e00\u6b65\u963b\u788d\u4e86\u8fd9\u4e00\u8fc7\u7a0b\u3002\u56e0\u6b64\uff0c\u5c3d\u7ba1\u653e\u5c04\u6cbb\u7597\u80fd\u591f\u5c06\u80bf\u7624\u8f6c\u53d8\u4e3a\u4e00\u4e2a\u514d\u75ab\u539f\u6027\u4e2d\u5fc3\uff0c\u5b83\u901a\u5e38\u5e76\u4e0d\u662f\u4e00\u4e2a\u7406\u60f3\u7684\u514d\u75ab\u6fc0\u6d3b\u65b9\u6cd5\u3002\u5728\u4e34\u5e8a\u4e0a\uff0c\u5927\u591a\u6570\u5df2\u8bc6\u522b\u7684\u764c\u75c7\u5177\u6709\u8f83\u4f4e\u7684\u514d\u75ab\u539f\u6027\u3002\u4e3a\u4e86\u6709\u6548\u542f\u52a8\u5f3a\u5927\u7684\u6297\u80bf\u7624T\u7ec6\u80de\u53cd\u5e94\uff0c\u9700\u8981\u91c7\u7528\u963b\u65ad\u514d\u75ab\u6291\u5236\u9014\u5f84\u6216\u589e\u5f3a\u514d\u75ab\u6fc0\u6d3b\u7684\u6cbb\u7597\u65b9\u6cd5\uff0c\u6bd4\u5982\u5df2\u5728\u4e34\u5e8a\u524d\u7814\u7a76\u4e2d\u6210\u529f\u5e94\u7528\u7684\u9776\u5411CTLA-4\u3001PD-1\u548cPDL-1\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\uff0c\u4ee5\u53ca\u6fc0\u6d3bCD137\u548cTLR\u6fc0\u52a8\u5242\u7684\u6fc0\u52a8\u6297\u4f53\u8054\u5408\u4f7f\u7528\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u81f3\u4e8e\u653e\u5c04\u6cbb\u7597\u662f\u5426\u80fd\u8bf1\u5bfc\u65b0\u6297\u539f\u7684\u751f\u6210\uff0c\u8fd9\u4e00\u95ee\u9898\u5c1a\u672a\u660e\u786e\u89e3\u51b3\u3002\u5728\u5927\u591a\u6570\u7814\u7a76\u4e2d\uff0c\u5df2\u901a\u8fc7\u5355\u72ec\u4f7f\u7528\u653e\u5c04\u6cbb\u7597\u6216\u4e0e\u514d\u75ab\u6cbb\u7597\u8054\u5408\u4f7f\u7528\u6765\u89e6\u53d1T\u7ec6\u80de\u53cd\u5e94\uff0c\u8fd9\u4e9b\u53cd\u5e94\u901a\u5e38\u9488\u5bf9\u5355\u4e00\u7684\u6297\u539f\u8868\u4f4d\uff0c\u4f8b\u5982\u5f15\u5165\u5230\u764c\u7ec6\u80de\u4e2d\u7684\u514d\u75ab\u663e\u6027\u5185\u6e90\u6027\u6297\u539f\u6216\u5916\u6e90\u6027\u62a5\u544a\u6297\u539f\uff08\u5982\u5375\u6e05\u86cb\u767d\uff0cOVA\uff09\u3002\u4e3a\u4e86\u5f15\u53d1\u66f4\u5e7f\u6cdb\u7684CD8+ <\/sup>T\u7ec6\u80de\u53cd\u5e94\uff0c\u6211\u4eec\u5206\u6790\u4e86\u5bf9\u764c\u7ec6\u80de\u4e2d\u8fc7\u8868\u8fbe\u7684\u4e09\u79cd\u6297\u539f\u7684\u56db\u79cd\u4e0d\u540c\u8868\u4f4d\u7684\u53cd\u5e94\uff1a\u6297\u51cb\u4ea1\u86cb\u767d\u751f\u5b58\u7d20\u3001\u4e0a\u76ae\u7ec6\u80de\u5411\u95f4\u8d28\u8f6c\u5316\uff08EMT\uff09\u8f6c\u5f55\u56e0\u5b50Twist\uff0c\u4ee5\u53ca\u5185\u6e90\u6027\u9006\u8f6c\u5f55\u75c5\u6bd2gp70\u7684\u5305\u819c\u3002\u5f53\u901a\u8fc7\u4e2d\u548cTGF-\u03b2\u6765\u963b\u6b62\u8f90\u5c04\u8bf1\u5bfc\u7684DC\u6fc0\u6d3b\u6291\u5236\u65f6\uff0c\u5bf9\u6240\u6709\u56db\u4e2a\u8868\u4f4d\u7684\u53cd\u5e94\u5747\u7531\u4f4e\u514d\u75ab\u539f\u6027\u7684\u5c0f\u9f204T1\u4e73\u817a\u764c\u6a21\u578b\u4e2d\u7684\u8f90\u5c04\u5f15\u53d1\u3002\u56e0\u6b64\uff0c\u53bb\u9664\u5173\u952e\u7684\u514d\u75ab\u6291\u5236\u969c\u788d\u91ca\u653e\u4e86\u8f90\u5c04\u7684\u6f5c\u529b\uff0c\u4ece\u800c\u89e6\u53d1\u5e7f\u6cdb\u7684T\u7ec6\u80de\u53cd\u5e94\u3002\u76ee\u524d\u6b63\u5728\u8fdb\u884c\u7684\u7814\u7a76\u5de5\u4f5c\u81f4\u529b\u4e8e\u5168\u9762\u8bc4\u4f30\u8f90\u5c04\u540e\u6fc0\u6d3b\u7684T\u7ec6\u80de\u514b\u9686\u5e93\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u9664\u4e86\u6297\u539f\u7279\u5f02\u6027\u5916\uff0c\u7531\u8f90\u5c04\u5f15\u53d1\u7684\u6297\u80bf\u7624T\u7ec6\u80de\u7684\u6570\u91cf\u548c\u6301\u4e45\u6027\u53ef\u80fd\u662f\u5b9e\u73b0\u5f02\u4f4d\u53cd\u5e94\u7684\u5173\u952e\u56e0\u7d20\u3002\u5b9e\u9645\u4e0a\uff0c\u5c3d\u7ba1\u8f90\u5c04\u53ef\u4ee5\u6210\u529f\u5730\u6e05\u9664\u539f\u4f4d\u80bf\u7624\uff0c\u4f5c\u4e3a\u4e00\u79cd\u4e25\u683c\u7684\u539f\u4f4d\u653e\u5c04\u63a5\u79cd\u6548\u679c\u7684\u6d4b\u8bd5\uff0c\u5f02\u4f4d\u53cd\u5e94\u5374\u5f88\u5c11\u89c1\u3002\u6b63\u5982\u524d\u6587\u7b2c30.3\u8282\u6240\u8ff0\uff0c\u8f90\u5c04\u5242\u91cf\u53ca\u5176\u5206\u7ea7\u7b56\u7565\u4f3c\u4e4e\u662f\u51b3\u5b9a\u653e\u5c04\u4e0e\u6297CTLA-4\u8054\u5408\u6cbb\u7597\u8bf1\u5bfc\u5f02\u4f4d\u53cd\u5e94\u80fd\u529b\u7684\u5173\u952e\u56e0\u7d20\u3002\u4f8b\u5982\uff0c\u91cd\u590d3\u52305\u6b21\u76846-8 Gy\u5242\u91cf\u80fd\u591f\u4ea7\u751f\u5f02\u4f4d\u53cd\u5e94\uff0c\u800c\u5355\u4e00\u9ad8\u5242\u91cf\u768420 Gy\u8f90\u5c04\u5219\u4e0d\u80fd\u3002\u6700\u65b0\u7684\u7814\u7a76\u6570\u636e\u8868\u660e\uff0c\u6709\u6548\u4e0e\u65e0\u6548\u7684\u653e\u7597\u65b9\u6848\u4e4b\u95f4\u7684\u5dee\u5f02\u53ef\u80fd\u6e90\u4e8e\u5b83\u4eec\u5728\u764c\u7ec6\u80de\u5185\u8bf1\u5bfcI\u578b\u5e72\u6270\u7d20\uff08IFN-I\uff09\u901a\u8def\u6d3b\u5316\u80fd\u529b\u7684\u4e0d\u540c\u3002\u7efc\u4e0a\u6240\u8ff0\uff0c\u5f53\u653e\u7597\u4f5c\u4e3a\u514d\u75ab\u6cbb\u7597\u7684\u8f85\u52a9\u63aa\u65bd\u65f6\uff0c\u6700\u4f73\u7684\u653e\u7597\u65b9\u6848\u53ef\u80fd\u4e0e\u5e38\u89c4\u653e\u5c04\u80bf\u7624\u5b66\u5b9e\u8df5\u4e2d\u91c7\u7528\u7684\u65b9\u6848\u6709\u6240\u4e0d\u540c\uff0c\u8fd9\u4e00\u70b9\u5728\u4e34\u5e8a\u5e94\u7528\u4e2d\u6781\u4e3a\u5173\u952e\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


<\/p>\n

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

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

\u521d\u7a3f\u7ffb\u8bd1 | \u6f58\u541b\u541b<\/span><\/p>\n

\u56fe\u6587\u6392\u7248 | \u6f58\u541b\u541b<\/span><\/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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