{"id":5666,"date":"2024-06-23T21:44:15","date_gmt":"2024-06-23T13:44:15","guid":{"rendered":"http:\/\/dh.oncolab.cn\/index.php\/2024\/06\/23\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac31%e7%ab%a0%ef%bc%9a%e5%85%8d%e7%96%ab%e6%a3%80%e6%9f%a5%e7%82%b9%e9%98%bb%e6%96%ad%e5%8f%8d%e5%ba%94%e7%9a%84%e9%a2%84%e6%b5%8b%e5%9b%a0\/"},"modified":"2024-06-23T21:44:15","modified_gmt":"2024-06-23T13:44:15","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac31%e7%ab%a0%ef%bc%9a%e5%85%8d%e7%96%ab%e6%a3%80%e6%9f%a5%e7%82%b9%e9%98%bb%e6%96%ad%e5%8f%8d%e5%ba%94%e7%9a%84%e9%a2%84%e6%b5%8b%e5%9b%a0","status":"publish","type":"post","link":"http:\/\/dh.oncolab.cn\/index.php\/2024\/06\/23\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac31%e7%ab%a0%ef%bc%9a%e5%85%8d%e7%96%ab%e6%a3%80%e6%9f%a5%e7%82%b9%e9%98%bb%e6%96%ad%e5%8f%8d%e5%ba%94%e7%9a%84%e9%a2%84%e6%b5%8b%e5%9b%a0\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c31\u7ae0\uff1a\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u9884\u6d4b\u56e0\u7d20(\u4e0a\uff09"},"content":{"rendered":"
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\u4e0a\u671f\u5185\u5bb9\uff1a\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c30\u7ae0\uff1a\u653e\u5c04\u6cbb\u7597\u4e0e\u514d\u75ab\u6cbb\u7597\u7684\u534f\u540c\u4f5c\u7528\uff08\u4e0b\uff09<\/span><\/a><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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

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\u5728\u8fc7\u53bb\u5341\u5e74\u4e2d\uff0c\u764c\u75c7\u6cbb\u7597\u9886\u57df\u7ecf\u5386\u4e86\u663e\u8457\u53d8\u9769\u3002\u6700\u521d\uff0c\u968f\u7740\u4e2a\u6027\u5316\u533b\u7597\u7684\u5174\u8d77\uff0c\u5206\u5b50\u9769\u547d\u91cd\u5851\u4e86\u6211\u4eec\u5bf9\u6cbb\u7597\u7684\u8ba4\u77e5\uff1b\u800c\u5982\u4eca\uff0c\u6709\u6548\u7684\u533b\u7597\u514d\u75ab\u6cbb\u7597\u7b56\u7565\u7684\u51fa\u73b0\u8fdb\u4e00\u6b65\u6df1\u5316\u4e86\u8fd9\u4e00\u53d8\u9769\u3002\u5f53\u524d\u7684\u514d\u75ab\u80bf\u7624\u5b66\u9769\u547d\u4e0d\u4ec5\u91cd\u65b0\u5b9a\u4e49\u4e86\u5bf9\u60a3\u8005\u5065\u5eb7\u3001\u6cbb\u7597\u9884\u671f\u548c\u6bd2\u6027\u7ba1\u7406\u7684\u7406\u89e3\uff0c\u8fd8\u56e0\u5176\u9776\u5411\u514d\u75ab\u8c03\u8282\u68c0\u67e5\u70b9\u7684\u72ec\u7279\u4f5c\u7528\u673a\u5236\uff0c\u63a8\u52a8\u4e86\u75be\u75c5\u8bc4\u4f30\u548c\u76d1\u6d4b\u65b9\u6cd5\u7684\u9769\u65b0\uff0c\u8981\u6c42\u4e0e\u4f20\u7edf\u6cbb\u7597\u6a21\u5f0f\u534f\u540c\u8fdb\u5316\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e3a\u4e86\u4f18\u5316\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u7684\u5e94\u7528\uff0c\u6211\u4eec\u7684\u6838\u5fc3\u4efb\u52a1\u662f\u8bc6\u522b\u53ef\u4ee5\u51c6\u786e\u53cd\u6620\u53cd\u5e94\u6027\u548c\u6bd2\u6027\u7684\u751f\u7269\u6807\u5fd7\u7269\u3002\u5728\u4e34\u5e8a\u4e0a\uff0c\u6709\u5fc5\u8981\u6700\u5927\u5316\u6cbb\u7597\u9009\u62e9\u4ee5\u63a8\u52a8\u8be5\u9886\u57df\u836f\u7269\u7684\u6301\u7eed\u53d1\u5c55\uff0c\u540c\u65f6\uff0c\u6211\u4eec\u4e5f\u9700\u5171\u540c\u6df1\u5316\u5bf9\u764c\u75c7\u57fa\u672c\u514d\u75ab\u751f\u7269\u5b66\u7684\u7406\u89e3\uff0c\u4ee5\u514d\u5bf9\u65b0\u836f\u7269\u4f5c\u7528\u53ca\u5176\u4f5c\u7528\u673a\u7406\u7684\u8ba4\u8bc6\u65e5\u76ca\u8131\u8282\u3002\u6df1\u5165\u63a2\u7d22\u80bf\u7624\u7ec6\u80de\u4e4b\u95f4\u7684\u590d\u6742\u76f8\u4e92\u4f5c\u7528\u3001\u5e7f\u6cdb\u7684\u80bf\u7624\u5fae\u73af\u5883\u4ee5\u53ca\u514d\u75ab\u7cfb\u7edf\u7684\u591a\u5c42\u9762\u5f71\u54cd\uff0c\u5bf9\u4e8e\u53d1\u73b0\u5177\u6709\u4e34\u5e8a\u610f\u4e49\u7684\u514d\u75ab\u6cbb\u7597\u9884\u6d4b\u56e0\u5b50\u81f3\u5173\u91cd\u8981\u3002\u91cd\u8981\u7684\u662f\uff0c\u6211\u4eec\u6b63\u5728\u9010\u6e10\u8ba4\u8bc6\u5230\uff0c\u65b0\u7684\u514d\u75ab\u80bf\u7624\u5b66\u7406\u8bba\u4e0e\u4f20\u7edf\u7684\u5206\u5b50\u81f4\u764c\u7406\u8bba\u662f\u5982\u4f55\u7d27\u5bc6\u76f8\u8fde\u7684\uff0c\u6b63\u5982Hanahan\u548cWeinberg\u57282011\u5e74\u5c06\u514d\u75ab\u9003\u9038\u89c6\u4e3a\u764c\u75c7\u7684\u4e00\u79cd\u65b0\u5174\u7279\u5f81\u6240\u4f53\u73b0\u7684\u90a3\u6837\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u672c\u7ae0\u4e2d\uff0c\u6211\u4eec\u5c06\u57fa\u4e8e\u63cf\u8ff0\u764c\u75c7\u4e0e\u514d\u75ab\u52a8\u6001\u76f8\u4e92\u4f5c\u7528\u7f51\u7edc\u7684\u5e7f\u6cdb\u548c\u5f00\u521b\u6027\u5de5\u4f5c\uff0c\u8be6\u7ec6\u9610\u8ff0\u6784\u6210\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u5206\u5b50\u548c\u7ec6\u80de\u673a\u5236\u3002\u6b64\u5916\uff0c\u6211\u4eec\u8fd8\u5c06\u63a2\u8ba8\u5f53\u524d\u548c\u65b0\u51fa\u73b0\u7684\u4e00\u4e9b\u56e0\u7d20\uff0c\u8fd9\u4e9b\u56e0\u7d20\u53ef\u80fd\u5bf9\u63a5\u53d7\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u6cbb\u7597\u7684\u60a3\u8005\u5177\u6709\u9884\u6d4b\u4ef7\u503c\uff0c\u5e76\u6709\u671b\u9002\u7528\u4e8e\u4f5c\u4e3a\u514d\u75ab\u523a\u6fc0\u5206\u5b50\u9776\u70b9\u7684\u65b0\u578b\u6cbb\u7597\u836f\u7269\u3002\u672a\u6765\u7684\u514d\u75ab\u6cbb\u7597\u4e34\u5e8a\u8bd5\u9a8c\u8bbe\u8ba1\u5c06\u5fc5\u987b\u8003\u8651\u8fd9\u4e9b\u751f\u7269\u6807\u5fd7\u7269\uff0c\u4ee5\u5b9e\u73b0\u5c06\u514d\u75ab\u6cbb\u7597\u771f\u6b63\u6574\u5408\u5230\u4e2a\u6027\u5316\u533b\u7597\u7684\u76ee\u6807\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.2  \u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u7279\u5f81<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e3a\u4e86\u6709\u6548\u76d1\u6d4b\u548c\u9884\u6d4b\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u7597\u6548\uff0c\u6211\u4eec\u9700\u8981\u6df1\u5165\u7406\u89e3\u764c\u75c7\u7684\u53d1\u751f\u673a\u5236\u3001\u75be\u75c5\u7684\u8fdb\u5c55\u8fc7\u7a0b\u4ee5\u53ca\u5168\u8eab\u6027\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u7684\u5e94\u7528\u77e5\u8bc6\u3002\u8fd9\u4e9b\u56e0\u7d20\uff0c\u52a0\u4e4b\u6765\u81ea\u66f4\u5e7f\u6cdb\u73af\u5883\u7684\u5916\u90e8\u5f71\u54cd\uff0c\u5bf9\u4e8e\u5851\u9020\u6cbb\u7597\u53cd\u5e94\u81f3\u5173\u91cd\u8981\u3002\u8fd9\u4e9b\u8981\u7d20\u5171\u540c\u4e3a\u6211\u4eec\u63d0\u4f9b\u4e86\u4e00\u4e2a\u5168\u9762\u7684\u6846\u67b6\uff0c\u5e2e\u52a9\u6211\u4eec\u7406\u89e3\u548c\u63cf\u7ed8\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u7279\u5f81(Fig 31.1<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 31.1<\/span> \u63cf\u8ff0\u4e86\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u7279\u5f81\u3002\u8bc6\u522b\u4e0e\u514d\u75ab\u68c0\u67e5\u70b9\u53cd\u5e94\u76f8\u5173\u7684\u9884\u6d4b\u56e0\u5b50\uff0c\u9700\u8981\u5168\u9762\u7406\u89e3\u591a\u79cd\u56e0\u7d20\u5bf9\u764c\u75c7\u53d1\u5c55\u53ca\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u7684\u5f71\u54cd\u3002\u8fd9\u4e9b\u56e0\u7d20\u5305\u62ec\u80bf\u7624\u672c\u8eab\u3001\u80bf\u7624\u5fae\u73af\u5883\u3001\u5c40\u90e8\u514d\u75ab\uff08\u5982\u80bf\u7624\u5468\u56f4\u73af\u5883\u53ca\u76f8\u90bb\u5f15\u6d41\u6dcb\u5df4\u7ed3\u4e2d\u7684\u514d\u75ab\u6d3b\u52a8\uff09\u3001\u7cfb\u7edf\u6027\u514d\u75ab\u53cd\u5e94\uff0c\u4ee5\u53ca\u5c40\u90e8\u53ca\u6269\u5c55\u73af\u5883\u7684\u7efc\u5408\u5f71\u54cd\u3002\u8be5\u56fe\u6982\u62ec\u4e86\u8fd9\u4e9b\u9886\u57df\u4e2d\u7684\u5173\u952e\u56e0\u7d20\uff0c\u7a81\u663e\u4e86\u5b83\u4eec\u4e4b\u95f4\u7684\u9ad8\u5ea6\u76f8\u4e92\u5173\u8054\u548c\u4f9d\u8d56\u6027\u3002\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u6700\u7ec8\u53cd\u5e94\u662f\u8fd9\u4e9b\u6b63\u53cd\u76f8\u4e92\u4f5c\u7528\u7684\u590d\u6742\u7efc\u5408\u4f53\uff1b\u56e0\u6b64\uff0c\u5728\u63a2\u7d22\u8fd9\u4e9b\u6cbb\u7597\u7684\u9884\u6d4b\u6027\u751f\u7269\u6807\u5fd7\u7269\u65f6\uff0c\u5fc5\u987b\u7efc\u5408\u8003\u8651\u6240\u6709\u8fd9\u4e9b\u56e0\u7d20\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.2.1  \u80bf\u7624\u4e0e\u5fae\u73af\u5883
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31.2.1.1 \u80bf\u7624\u57fa\u56e0\u7ec4\u5b66\u4e0e\u8868\u89c2\u57fa\u56e0\u7ec4\u5b66<\/p>\n<\/section>\n

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\u968f\u7740\u4e8c\u4ee3\u6d4b\u5e8f\u6280\u672f\u7684\u5e94\u7528\uff0c\u6211\u4eec\u5728\u7406\u89e3\u764c\u75c7\u7684\u53d1\u751f\u548c\u8fdb\u5c55\u65b9\u9762\u53d6\u5f97\u4e86\u91cd\u5927\u8fdb\u5c55\u3002\u8fd9\u4e9b\u6280\u672f\u5df2\u7ecf\u88ab\u6574\u5408\u5230\u4e34\u5e8a\u62a4\u7406\u4e2d\uff0c\u5168\u7403\u8303\u56f4\u5185\u7684\u9776\u5411\u6d4b\u5e8f\u9762\u677f\u6b63\u5728\u7528\u4e8e\u591a\u79cd\u764c\u75c7\u7c7b\u578b\uff0c\u4e3a\u6cbb\u7597\u51b3\u7b56\u63d0\u4f9b\u652f\u6301\uff0c\u5c24\u5176\u662f\u5728\u6307\u5bfc\u5206\u5b50\u9776\u5411\u6cbb\u7597\u65b9\u9762\u3002\u6b64\u5916\uff0c\u57fa\u56e0\u7ec4\u5b66\u5206\u6790\u5728\u8003\u8651\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u65f6\u4e5f\u663e\u5f97\u5c24\u4e3a\u91cd\u8981\uff0c\u56e0\u4e3a\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u8868\u660e\uff0c\u67d0\u4e9b\u5206\u5b50\u53d8\u5f02\u4e0e\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u5bc6\u5207\u76f8\u5173\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u901a\u8fc7\u9879\u76ee\u5982\u764c\u75c7\u57fa\u56e0\u7ec4\u56fe\u8c31\uff08TCGA\uff09\u7684\u7814\u7a76\uff0c\u6211\u4eec\u5bf9\u80bf\u7624\u7684\u57fa\u56e0\u7ec4\u7279\u5f81\u6709\u4e86\u6df1\u5165\u7684\u7406\u89e3\uff0c\u8fdb\u4e00\u6b65\u63ed\u793a\u4e86\u4e0d\u540c\u764c\u75c7\u7c7b\u578b\u7684\u7a81\u53d8\u7c7b\u578b\u548c\u8d1f\u62c5\u3002\u5728\u8fd9\u91cc\uff0c\u7a81\u53d8\u7684\u8d28\u91cf\u548c\u6570\u91cf\u90fd\u6781\u4e3a\u5173\u952e\uff0c\u5b83\u4eec\u53ef\u80fd\u5f71\u54cd\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u53ca\u5176\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u53cd\u5e94\u6027\u3002\u4f8b\u5982\uff0c\u603b\u7a81\u53d8\u8d1f\u8377\uff08TMB\uff09\u53ef\u80fd\u4f1a\u5f71\u54cd\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u7684\u53cd\u5e94\uff1b\u901a\u5e38\u60c5\u51b5\u4e0b\uff0c\u5177\u6709\u8f83\u9ad8\u7a81\u53d8\u7387\u6216DNA\u9519\u914d\u4fee\u590d\uff08MMR\uff09\u57fa\u56e0\u7f3a\u9677\u7684\u764c\u75c7\u66f4\u53ef\u80fd\u5bf9\u8fd9\u7c7b\u7597\u6cd5\u4ea7\u751f\u53cd\u5e94\u3002\u8fd9\u79cd\u73b0\u8c61\u53ef\u80fd\u662f\u56e0\u4e3a\u8fd9\u4e9b\u764c\u75c7\u4ea7\u751f\u8f83\u9ad8\u7684\u65b0\u6297\u539f\u8d1f\u8377\uff08\u65b0\u6297\u539f\u6307\u7684\u662f\u7531\u4f53\u7ec6\u80de\u7a81\u53d8\u4e8b\u4ef6\u4ea7\u751f\u7684\u80bf\u7624\u76f8\u5173\u6297\u539f\uff09\uff0c\u8fd9\u4e9b\u6297\u539f\u56e0\u4e3a\u4e0d\u88ab\u5176\u4ed6\u201c\u6b63\u5e38\u201d\u7ec4\u7ec7\u8868\u8fbe\uff0c\u4ece\u800c\u53ef\u80fd\u7531\u4e8e\u5b58\u5728\u4e0d\u8010\u53d7\u7684\u65b0\u6297\u539f\u53cd\u5e94\u6027T\u7ec6\u80de\u800c\u663e\u793a\u51fa\u66f4\u9ad8\u7684\u514d\u75ab\u539f\u6027\u3002\u7136\u800c\uff0c\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0c\u5c3d\u7ba1\u4f20\u7edf\u7b97\u6cd5\u80fd\u9884\u6d4b\u51fa\u5b9e\u9645\u8868\u8fbe\u7684\u65b0\u6297\u539f\uff0c\u4f46\u8fd9\u4e9b\u80fd\u5f15\u53d1\u6709\u6548\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u7684\u65b0\u6297\u539f\u6bd4\u4f8b\u76f8\u5bf9\u8f83\u5c11\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7a81\u53d8\u5728\u764c\u75c7\u6cbb\u7597\u4e2d\u53ef\u89c6\u4e3a\u4e00\u628a\u201c\u53cc\u5203\u5251\u201d\uff0c\u56e0\u4e3a\u5b83\u4eec\u65e2\u53ef\u4ee5\u89e6\u53d1\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\uff0c\u4e5f\u53ef\u80fd\u5bfc\u81f4\u6cbb\u7597\u8010\u836f\u6027\u3002\u8d8a\u6765\u8d8a\u591a\u7684\u4f8b\u5b50\u663e\u793a\uff0c\u57fa\u56e0\u7ec4\u7a81\u53d8\u53ca\u5176\u4ed6\u57fa\u56e0\u7ec4\u6216\u8868\u89c2\u57fa\u56e0\u7ec4\u7684\u6539\u53d8\u4f1a\u524a\u5f31\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u6548\u679c\u3002\u4f8b\u5982\uff0c\u5206\u5b50\u7684\u7a81\u53d8\u3001\u62f7\u8d1d\u6570\u6539\u53d8\u6216\u8868\u8fbe\u6a21\u5f0f\u7684\u6539\u53d8\u53ef\u80fd\u4f1a\u5e72\u6270\u6b63\u5e38\u7684\u6297\u539f\u5904\u7406\u548c\u5448\u9012\u673a\u5236\uff0c\u5df2\u6709\u7814\u7a76\u63cf\u8ff0\u4e86HLA\uff08\u4eba\u7c7b\u767d\u7ec6\u80de\u6297\u539f\uff09\u548c\u03b2-2\u5fae\u7403\u86cb\u767d\u5728\u8fd9\u65b9\u9762\u7684\u5f02\u5e38\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u540c\u6837\u91cd\u8981\u7684\u662f\uff0c\u6211\u4eec\u9700\u6ce8\u610f\u5230\u81f4\u764c\u57fa\u56e0\u7ec4\u6216\u8868\u89c2\u57fa\u56e0\u7ec4\u7684\u6539\u53d8\u53ef\u80fd\u4f1a\u5bfc\u81f4\u80bf\u7624\u7279\u5f02\u6027\u6297\u539f\u7684\u8868\u8fbe\u4e0b\u8c03\u3002\u9488\u5bf9\u8fd9\u4e9b\u6539\u53d8\u7684\u6cbb\u7597\u53ef\u80fd\u589e\u5f3a\u6297\u539f\u8868\u8fbe\uff0c\u4ece\u800c\u63d0\u5347\u6cbb\u7597\u6548\u679c\u3002\u4f8b\u5982\uff0c\u5728\u9ed1\u8272\u7d20\u7624\u4e2d\uff0c\u9488\u5bf9V600E\u7a81\u53d8\u7684BRAF\u7684\u6fc0\u9176\u6291\u5236\u5242\u5c31\u80fd\u663e\u8457\u63d0\u5347\u6cbb\u7597\u6548\u679c\u3002\u6b64\u5916\uff0c\u5728\u591a\u79cd\u764c\u75c7\u7c7b\u578b\u4e2d\uff0c\u5bf9\u764c\u75c7\u777e\u4e38\u6297\u539f\u8868\u8fbe\u7684\u8868\u89c2\u9057\u4f20\u8c03\u63a7\u4e5f\u4f53\u73b0\u4e86\u7c7b\u4f3c\u6548\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5176\u4ed6\u4e0e\u764c\u75c7\u8fdb\u5c55\u76f8\u5173\u7684\u7a81\u53d8\u6216\u6539\u53d8\u53ef\u80fd\u5f71\u54cd\u514d\u75ab\u8c03\u8282\u4f5c\u7528\uff0c\u8fdb\u800c\u5f71\u54cd\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u6548\u679c\u3002\u4f8b\u5982\uff0c\u5728\u80ba\u764c\u4e2d\uff0cAKT-mTOR\u6216EGFR\u901a\u8def\u7684\u6fc0\u6d3b\u53ef\u80fd\u5bfc\u81f4\u7a0b\u5e8f\u6027\u6b7b\u4ea1\u53d7\u4f53\u914d\u4f53-1\uff08PD-L1\uff09\u8868\u8fbe\u589e\u52a0\uff0c\u800c\u80bf\u7624\u6291\u5236\u57fa\u56e0PTEN\u529f\u80fd\u4e0d\u8db3\u53ef\u80fd\u8bf1\u5bfc\u514d\u75ab\u6291\u5236\u7ec6\u80de\u56e0\u5b50\u73af\u5883\uff0c\u4ece\u800c\u524a\u5f31\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u53cd\u5e94\u3002\u6b64\u5916\uff0c\u80bf\u7624\u5185\u5e72\u6270\u7d20\u4fe1\u53f7\u7684\u7f3a\u9677\u4e5f\u53ef\u80fd\u5bfc\u81f4\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u62b5\u6297\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.2.1.2 \u80bf\u7624\u5fae\u73af\u5883<\/p>\n<\/section>\n

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\u5728\u8003\u8651\u764c\u75c7\u6cbb\u7597\u53cd\u5e94\u65f6\uff0c\u9664\u4e86\u80bf\u7624\u7684\u5206\u5b50\u53d8\u5316\uff0c\u80bf\u7624\u5fae\u73af\u5883\u7684\u8c03\u8282\u4f5c\u7528\u4e5f\u662f\u4e0d\u53ef\u5ffd\u89c6\u7684\u3002\u5b9e\u9645\u4e0a\uff0c\u80bf\u7624\u6784\u6210\u4e86\u4e00\u4e2a\u590d\u6742\u7684\u751f\u6001\u7cfb\u7edf\uff0c\u5b83\u4e0d\u4ec5\u5305\u62ec\u80bf\u7624\u7ec6\u80de\u672c\u8eab\uff0c\u8fd8\u6db5\u76d6\u4e86\u8840\u7ba1\u3001\u80bf\u7624\u6d78\u6da6\u514d\u75ab\u7ec6\u80de\u3001\u7ec6\u80de\u56e0\u5b50\u4ee5\u53ca\u5176\u4ed6\u591a\u79cd\u57fa\u8d28\u6210\u5206\uff0c\u5982\u6210\u7ea4\u7ef4\u7ec6\u80de\u3001\u9ad3\u7cfb\u6291\u5236\u7ec6\u80de\u3001\u7ec6\u80de\u5916\u57fa\u8d28\u548c\u5176\u4ed6\u7ec6\u80de\u5b9e\u4f53\u3002\u8fd9\u4e9b\u6210\u5206\u76f8\u4e92\u4f5c\u7528\uff0c\u4fc3\u8fdb\u764c\u75c7\u7684\u53d1\u5c55\uff0c\u5e76\u53ef\u80fd\u5f71\u54cd\u6cbb\u7597\u53cd\u5e94\u53ca\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u62b5\u6297\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Hanahan \u548c Weinberg \u4ee5\u53ca Schreiber \u7684\u5f00\u521b\u6027\u7814\u7a76\u4e3a\u6211\u4eec\u7406\u89e3\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u4e0d\u540c\u6210\u5206\u7684\u529f\u80fd\u5960\u5b9a\u4e86\u575a\u5b9e\u7684\u57fa\u7840\u3002\u4ed6\u4eec\u5206\u522b\u63cf\u8ff0\u4e86\u201c\u764c\u75c7\u7684\u751f\u7269\u6807\u5fd7\u201d\u548c\u514d\u75ab\u7f16\u8f91\u539f\u7406\uff0c\u8fd9\u4e9b\u539f\u7406\u63ed\u793a\u4e86\u80bf\u7624\u751f\u957f\u548c\u8f6c\u79fb\u7684\u673a\u5236\uff0c\u4ee5\u53ca\u80bf\u7624\u7ec6\u80de\u4e0e\u514d\u75ab\u7ec6\u80de\u4e4b\u95f4\u7d27\u5bc6\u800c\u52a8\u6001\u7684\u76f8\u4e92\u4f5c\u7528\uff0c\u8fd9\u4e9b\u76f8\u4e92\u4f5c\u7528\u53ef\u80fd\u5bfc\u81f4\u80bf\u7624\u7684\u6d88\u9664\u3001\u5e73\u8861\u6216\u9003\u9038\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7ee7\u8fd9\u4e9b\u5de5\u4f5c\u4e4b\u540e\uff0c\u5176\u4ed6\u7814\u7a76\u8005\u8fdb\u4e00\u6b65\u63cf\u8ff0\u4e86\u201c\u764c\u75c7\u514d\u75ab\u5faa\u73af\u201d\u3001\u201c\u764c\u75c7\u514d\u75ab\u8bbe\u5b9a\u70b9\u201d\u548c\u201c\u764c\u75c7\u514d\u75ab\u56fe\u8c31\u201d\u3002\u8fd1\u5e74\u6765\uff0c\u8fd9\u4e9b\u6982\u5ff5\u5728\u4f7f\u7528\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u7684\u6cbb\u7597\u4e2d\u5f97\u5230\u4e86\u6df1\u5165\u63a2\u8ba8\uff0c\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u7279\u5f81\u4e5f\u88ab\u76f8\u7ee7\u63cf\u8ff0\u51fa\u6765\u3002\u8fd9\u4e9b\u7814\u7a76\u90fd\u8ba4\u8bc6\u5230\u4e86\u80bf\u7624\u7ec6\u80de\u3001\u5fae\u73af\u5883\u5185\u7684\u7ec6\u80de\u4ee5\u53ca\u5916\u90e8\u5f71\u54cd\u4e4b\u95f4\u7684\u590d\u6742\u5173\u7cfb\uff0c\u5e76\u52aa\u529b\u63ed\u793a\u8fd9\u4e9b\u56e0\u7d20\u662f\u5982\u4f55\u5f71\u54cd\u6cbb\u7597\u53cd\u5e94\u7684\u3002\u867d\u7136\u6211\u4eec\u5c1a\u672a\u5b8c\u5168\u7406\u89e3\u8fd9\u4e9b\u590d\u6742\u8fc7\u7a0b\u7684\u5168\u90e8\u7ec6\u8282\uff0c\u968f\u7740\u65b0\u6570\u636e\u7684\u4e0d\u65ad\u51fa\u73b0\uff0c\u73b0\u6709\u6a21\u578b\u53ca\u5176\u5b83\u6a21\u578b\u5c06\u901a\u8fc7\u8fed\u4ee3\u65b9\u6cd5\u8fdb\u884c\u4fee\u6b63\u548c\u5b8c\u5584\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u63a7\u5236\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u4e00\u4e2a\u5173\u952e\u56e0\u7d20\u662f\u80fd\u5426\u5c06T\u7ec6\u80de\u6709\u6548\u5730\u6392\u9664\u5728\u80bf\u7624\u5fae\u73af\u5883\u4e4b\u5916\u3002\u591a\u5e74\u6765\uff0c\u80bf\u7624\u5185T\u7ec6\u80de\u7684\u6d78\u6da6\u5df2\u88ab\u8ba4\u4e3a\u662f\u4e0e\u591a\u79cd\u7c7b\u578b\u80bf\u7624\u826f\u597d\u9884\u540e\u76f8\u5173\u7684\u91cd\u8981\u6307\u6807\u3002\u6700\u8fd1\u7684\u7814\u7a76\u5bf9CD8+ T\u7ec6\u80de\u5728\u80bf\u7624\u4e2d\u7684\u5bc6\u5ea6\u548c\u5206\u5e03\u8fdb\u884c\u4e86\u8bc4\u4f30\uff0c\u7279\u522b\u662f\u5176\u5728\u80bf\u7624\u4e2d\u5fc3\u6216\u6d78\u6da6\u8fb9\u7f18\u7684\u4f4d\u7f6e\uff0c\u4ee5\u53ca\u8fd9\u4e9b\u4f4d\u7f6e\u4e0e\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u5173\u7cfb\u3002<\/p>\n

\u901a\u8fc7\u7ed3\u6784\u548c\u57fa\u56e0\u8868\u8fbe\u8c31\u7684\u5206\u6790\uff0c\u7814\u7a76\u4eba\u5458\u80fd\u591f\u5c06\u80bf\u7624\u5fae\u73af\u5883\u5206\u7c7b\u4e3a\u51e0\u79cd\u4e0d\u540c\u7684\u8868\u578b\uff0c\u5982\u201c\u708e\u75c7\u578b\u201d\u4e0e\u201c\u975e\u708e\u75c7\u578b\u201d\uff0c\u5e76\u8fdb\u4e00\u6b65\u7ec6\u5206\u4e3a\u201c\u514d\u75ab\u7f3a\u9677\u201d\u3001\u201c\u514d\u75ab\u6392\u65a5\u201d\u6216\u201c\u708e\u75c7\u578b\u201d\u3002\u514d\u75ab\u6392\u65a5\u7684\u673a\u5236\u5305\u62ec\u53ef\u80fd\u6e90\u4e8e\u80bf\u7624\u7ec6\u80de\u672c\u8eab\u7684\u56e0\u7d20\uff0c\u5982Wnt\/\u03b2-catenin\uff08\u8fde\u73af\u86cb\u767d\uff09\u901a\u8def\u7f3a\u9677\u6216MAPK\u8fc7\u5ea6\u6fc0\u6d3b\u3002\u6b64\u5916\uff0c\u514d\u75ab\u6392\u65a5\u4e5f\u53ef\u80fd\u7531\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u7684\u5176\u4ed6\u7ec6\u80de\u6210\u5206\u9a71\u52a8\uff0c\u4f8b\u5982\u9ad3\u7cfb\u6291\u5236\u7ec6\u80de\uff08MDSCs\uff09\uff0c\u6216\u662f\u7531\u5982\u8840\u7ba1\u5185\u76ae\u751f\u957f\u56e0\u5b50\uff08VEGF\uff09\u3001\u767d\u4ecb\u7d201\uff08IL-1\uff09\u548c\u767d\u4ecb\u7d206\uff08IL-6\uff09\u7b49\u5206\u6ccc\u56e0\u5b50\u5f15\u8d77\u3002<\/p>\n

\u6df1\u5165\u7406\u89e3\u8fd9\u4e9b\u56e0\u7d20\u5bf9\u4e8e\u8bbe\u8ba1\u6709\u6548\u7684\u514d\u75ab\u76d1\u6d4b\u7b56\u7565\u81f3\u5173\u91cd\u8981\uff0c\u5c24\u5176\u662f\u5728\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u6cbb\u7597\u4e2d\u3002\u6b64\u5916\uff0c\u8fd9\u4e9b\u77e5\u8bc6\u4e5f\u5bf9\u4e8e\u5408\u7406\u8bbe\u8ba1\u514b\u670d\u6cbb\u7597\u8010\u836f\u6027\u7684\u7b56\u7565\u81f3\u5173\u91cd\u8981\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.2.2  \u514d\u75ab\u529b<\/p>\n<\/section>\n

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\u9664\u4e86\u80bf\u7624\u548c\u5fae\u73af\u5883\u5916\uff0c\u5bbf\u4e3b\u7684\u6574\u4f53\u514d\u75ab\u72b6\u6001\u4e5f\u5728\u8c03\u8282\u80bf\u7624\u7684\u751f\u957f\u3001\u6269\u6563\u53ca\u5bf9\u6cbb\u7597\u7684\u54cd\u5e94\u4e2d\u626e\u6f14\u4e86\u5173\u952e\u89d2\u8272\u3002\u514d\u75ab\u53cd\u5e94\u662f\u52a8\u6001\u7684\uff0c\u4e0d\u4ec5\u7531\u6297\u539f\u523a\u6fc0\u5f15\u53d1\uff0c\u8fd8\u53d7\u5230\u5bbf\u4e3b\u5185\u5916\u56e0\u7d20\u7684\u5f71\u54cd(Fig 31.1<\/span>)\u3002\u6b7b\u4ea1\u7684\u80bf\u7624\u7ec6\u80de\u788e\u7247\u88ab\u6811\u7a81\u72b6\u7ec6\u80de\u7b49\u5bbf\u4e3b\u6297\u539f\u63d0\u5448\u7ec6\u80de\u6444\u53d6\uff0c\u5e76\u7ecf\u5904\u7406\u540e\u5448\u9012\u7ed9CD4+\uff08\u8f85\u52a9\uff09\u548cCD8+\uff08\u7ec6\u80de\u6bd2\u6027\uff09T\u6dcb\u5df4\u7ec6\u80de\u3002\u7136\u800c\uff0c\u51b3\u5b9a\u8fd9\u79cdT\u7ec6\u80de\u4e0e\u6297\u539f\u76f8\u4e92\u4f5c\u7528\u547d\u8fd0\u7684\uff0c\u4e0d\u4ec5\u662f\u6297\u539f\u63d0\u5448\uff0c\u8fd8\u5305\u62ec\u989d\u5916\u7684\u4fe1\u53f7\uff08\u5982\u5171\u523a\u6fc0\u548c\u5171\u6291\u5236\u4fe1\u53f7\uff09\u4ee5\u53ca\u5206\u6ccc\u56e0\u5b50\uff0c\u8fd9\u4e9b\u56e0\u7d20\u5171\u540c\u5bfc\u81f4T\u7ec6\u80de\u88ab\u6fc0\u6d3b\u4ea7\u751f\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u6216\u53d8\u5f97\u65e0\u53cd\u5e94\u6027\u3002<\/p>\n

\u7136\u800c\uff0cT\u7ec6\u80de\u5bf9\u5448\u9012\u6297\u539f\u7684\u8bc6\u522b\u4ec5\u662f\u514d\u75ab\u53cd\u5e94\u4e2d\u7684\u7b2c\u4e00\u6b65\u3002\u6b64\u540e\u7684\u4efb\u4f55\u9636\u6bb5\uff0c\u5305\u62ec\u542f\u52a8\u3001\u8fd0\u8f93\u3001\u80bf\u7624\u6d78\u6da6\u3001T\u7ec6\u80de\u4e0e\u80bf\u7624\u7ec6\u80de\u7684\u63a5\u5408\uff0c\u90fd\u53d7\u5230\u514d\u75ab\u8c03\u8282\u7684\u5f71\u54cd\uff0c\u65e0\u8bba\u8fd9\u4e9b\u8c03\u8282\u662f\u6765\u81ea\u5c40\u90e8\u8fd8\u662f\u8fdc\u5904\uff0c\u90fd\u53ef\u80fd\u635f\u5bb3\u539f\u672c\u6709\u6548\u7684\u514d\u75ab\u53cd\u5e94(Fig 31.2<\/span>)\u3002\u8fd9\u79cd\u590d\u6742\u7684\u514d\u75ab\u8c03\u8282\u673a\u5236\u7a81\u663e\u4e86\u5728\u764c\u75c7\u6cbb\u7597\u4e2d\u7406\u89e3\u548c\u64cd\u63a7\u514d\u75ab\u7cfb\u7edf\u7684\u91cd\u8981\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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

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Fig 31.2<\/span> \u5f53\u524d\u548c\u65b0\u5174\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u9884\u6d4b\u6307\u6807\u3002\u73b0\u6709\u7684\u9884\u6d4b\u56e0\u7d20\u4e3b\u8981\u4fa7\u91cd\u4e8e\u57fa\u4e8e\u80bf\u7624\u7684\u8bc4\u4f30\uff08\u4ee5\u7070\u8272\u6807\u8bc6\uff09\uff0c\u8fd9\u5305\u62ec\u80bf\u7624\u7a81\u53d8\u53ca\u76f8\u5173\u7684\u65b0\u6297\u539f\u8d1f\u8f7d\u3001\u80bf\u7624\u7ec6\u80de\u56fa\u6709\u7684\u514d\u75ab\u6291\u5236\u53ca\u9003\u907f\u673a\u5236\uff0c\u4ee5\u53ca\u5fae\u73af\u5883\u56e0\u7d20\uff0c\u7279\u522b\u662f\u6fc0\u6d3b\u7684CD8+ T\u7ec6\u80de\u7684\u6d78\u6da6\u60c5\u51b5\u3002\u65b0\u51fa\u73b0\u7684\u9884\u6d4b\u56e0\u7d20\u5728\u8fd9\u4e9b\u57fa\u7840\u4e0a\u8fdb\u884c\u6269\u5c55\uff0c\u8303\u56f4\u66f4\u5e7f\uff0c\u5305\u62ec\u5386\u53f2\u56e0\u7d20\u4ee5\u53ca\u6765\u81ea\u5176\u4ed6\u751f\u7269\u5b66\u533a\u5ba4\u7684\u751f\u7269\u6807\u5fd7\u7269\uff1b\u5176\u4e2d\u5305\u62ec\u653e\u5c04\u5b66\u8bc4\u4f30\uff08\u4ee5\u7eff\u8272\u6807\u8bc6\uff09\u3001\u4e34\u5e8a\u56e0\u7d20\uff08\u4ee5\u84dd\u8272\u6807\u8bc6\uff09\u3001\u8840\u6db2\u751f\u7269\u6807\u5fd7\u7269\uff08\u4ee5\u7ea2\u8272\u6807\u8bc6\uff09\u4ee5\u53ca\u73af\u5883\u56e0\u7d20\uff0c\u5f53\u524d\u7279\u522b\u5173\u6ce8\u80a0\u9053\u5fae\u751f\u7269\u7ec4\uff08\u4ee5\u68d5\u8272\u6807\u8bc6\uff09\u7684\u5f71\u54cd\u3002\u8fd9\u4e9b\u56e0\u7d20\u5171\u540c\u6784\u6210\u4e86\u4e00\u4e2a\u591a\u7ef4\u5ea6\u7684\u8bc4\u4f30\u7cfb\u7edf\uff0c\u7528\u4e8e\u9884\u6d4b\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7597\u6cd5\u7684\u53cd\u5e94\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u957f\u671f\u4ee5\u6765\uff0c\u4eba\u4eec\u5df2\u7ecf\u8ba4\u8bc6\u5230\u6574\u4f53\u5bbf\u4e3b\u514d\u75ab\u5bf9\u764c\u75c7\u7684\u53d1\u5c55\u548c\u8fdb\u5c55\u6709\u7740\u663e\u8457\u5f71\u54cd\u3002\u4ece19\u4e16\u7eaa\u672b\u5173\u4e8e\u764c\u75c7\u81ea\u53d1\u6d88\u9000\u7684\u62a5\u544a\uff0c\u5230\u4f7f\u7528Coley\u2019s\u6bd2\u7d20\u7b49\u5fae\u751f\u7269\u4ea7\u54c1\u8bf1\u5bfc\u6297\u764c\u514d\u75ab\u53cd\u5e94\u7684\u6982\u5ff5\uff0c\u5386\u53f2\u8bc1\u636e\u4e0d\u65ad\u5f3a\u8c03\u4e86\u514d\u75ab\u7cfb\u7edf\u7684\u4f5c\u7528\u3002\u6b64\u5916\uff0c\u514d\u75ab\u6291\u5236\u60a3\u8005\u60a3\u591a\u79cd\u764c\u75c7\u7684\u98ce\u9669\u589e\u52a0\u7684\u73b0\u8c61\u4e5f\u8bc1\u5b9e\u4e86\u514d\u75ab\u7cfb\u7edf\u7684\u91cd\u8981\u6027\u3002\u8fd9\u4e9b\u6982\u5ff5\u5f97\u5230\u4e86Schreiber\u7684\u5f00\u521b\u6027\u5de5\u4f5c\u7684\u8fdb\u4e00\u6b65\u4f50\u8bc1\uff0c\u5176\u4e2d\u63cf\u8ff0\u4e86\u514d\u75ab\u7f16\u8f91\u7684\u201c\u4e09\u4e2aE\u201d\uff0c\u5f3a\u8c03\u4e86\u5bbf\u4e3b\u514d\u75ab\u4e0e\u80bf\u7624\u4e4b\u95f4\u7684\u7d27\u5bc6\u76f8\u4e92\u4f5c\u7528\uff0c\u5c3d\u7ba1\u8fd9\u79cd\u4f5c\u7528\u4e3b\u8981\u53d1\u751f\u5728\u80bf\u7624\u5fae\u73af\u5883\u5c42\u9762\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u73b0\u4eca\uff0c\u8d8a\u6765\u8d8a\u591a\u7684\u7814\u7a76\u8868\u660e\u5168\u8eab\u514d\u75ab\u72b6\u6001\u5bf9\u80bf\u7624\u7684\u6392\u65a5\u53cd\u5e94\u548c\u514d\u75ab\u6cbb\u7597\u53cd\u5e94\u7684\u6df1\u8fdc\u5f71\u54cd\u3002\u6700\u8fd1\u7684\u7814\u7a76\u62a5\u544a\u8fdb\u4e00\u6b65\u63cf\u7ed8\u4e86\u4f53\u5185\u591a\u4e2a\u533a\u5ba4\u4e2d\u4e0d\u540c\u7c7b\u578b\u7ec6\u80de\u5728\u5f62\u6210\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u4e2d\u7684\u590d\u6742\u89d2\u8272\uff0c\u8bc1\u660e\u4e86\u5916\u5468\u514d\u75ab\u6fc0\u6d3b\u7684\u5fc5\u8981\u6027\uff0c\u4ee5\u53ca\u8fd9\u79cd\u6fc0\u6d3b\u4e25\u91cd\u4f9d\u8d56\u4e8eCD4+<\/sup> T\u7ec6\u80de\u3002\u5916\u5468\u7684PD-L1\u8868\u8fbe\u5df2\u88ab\u8ba4\u4e3a\u662f\u514d\u75ab\u9003\u9038\u7684\u4e3b\u8981\u9a71\u52a8\u56e0\u7d20\u3002\u6b64\u5916\uff0c\u5df2\u77e54-1BB\u6216PD-1\u7684\u8868\u8fbe\u80fd\u5728\u80bf\u7624\u6dcb\u5df4\u7ec6\u80de\u548c\u5faa\u73af\u6dcb\u5df4\u7ec6\u80de\u4e2d\u5bcc\u96c6\u80bf\u7624\u53cd\u5e94\u6027T\u7ec6\u80de\uff0c\u8fd9\u6697\u793a\u4e86\u4e00\u4e2a\u53ef\u80fd\u4e0e\u80bf\u7624\u53cd\u5e94\u6027T\u7ec6\u80de\u7fa4\u7684\u5efa\u7acb\u548c\u7ef4\u6301\u76f8\u5173\u7684\u5c1a\u672a\u5b8c\u5168\u4e86\u89e3\u7684\u514d\u75ab\u5faa\u73af\u3002\u56e0\u6b64\uff0c\u5728\u8003\u8651\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u9884\u6d4b\u56e0\u7d20\u65f6\uff0c\u7efc\u5408\u8003\u8651\u5bbf\u4e3b\u7684\u6574\u4f53\u514d\u75ab\u72b6\u6001\u663e\u5f97\u5c24\u4e3a\u91cd\u8981\u3002\u7136\u800c\uff0c\u5b9e\u73b0\u7406\u60f3\u7684\u5168\u9762\u7cfb\u7edf\u7684\u514d\u75ab\u76d1\u6d4b\u7b56\u7565\u4ecd\u7136\u662f\u4e00\u4e2a\u6311\u6218\uff0c\u9700\u8981\u8fdb\u4e00\u6b65\u7684\u5e7f\u6cdb\u7814\u7a76\u548c\u5f00\u53d1\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.2.3 \u73af\u5883<\/p>\n<\/section>\n

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\u9664\u4e86\u8003\u8651\u80bf\u7624\u3001\u5fae\u73af\u5883\u548c\u5bbf\u4e3b\u514d\u75ab\u7b49\u5185\u90e8\u56e0\u7d20\u5916\uff0c\u8fd8\u5fc5\u987b\u8ba4\u8bc6\u5230\u66f4\u5e7f\u6cdb\u7684\u73af\u5883\u56e0\u7d20\u5bf9\u764c\u75c7\u7684\u53d1\u751f\u3001\u53d1\u5c55\u548c\u6cbb\u7597\u53cd\u5e94\u7684\u5f71\u54cd\u3002\u8fd9\u4e9b\u5916\u90e8\u56e0\u7d20\u4e0e\u5c40\u90e8\u6216\u5bbf\u4e3b\u514d\u75ab\u7684\u51b3\u5b9a\u56e0\u7d20\u5171\u540c\u4f5c\u7528\uff0c\u5305\u62ec\u5916\u754c\u73af\u5883\u7684\u7269\u7406\u56e0\u7d20\u5982\u7d2b\u5916\u7ebf\u8f90\u5c04\u548c\u81f4\u764c\u7269\u8d28\uff08\u4f8b\u5982\u70df\u8349\u70df\u96fe\uff09\u7684\u66b4\u9732\uff0c\u996e\u98df\u548c\u5fae\u751f\u7269\u7fa4\u5e26\u6765\u7684\u751f\u7269\u5f71\u54cd\uff0c\u4ee5\u53ca\u538b\u529b\u5e26\u6765\u7684\u795e\u7ecf\u751f\u7406\u5f71\u54cd\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u73af\u5883\u56e0\u7d20\u53ef\u4ee5\u663e\u8457\u5f71\u54cd\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u6548\u679c\u3002\u6700\u660e\u663e\u7684\u4f8b\u5b50\u4e4b\u4e00\u662f\uff0c\u7d2b\u5916\u7ebf\u66b4\u9732\u548c\u5438\u70df\u6240\u5bfc\u81f4\u7684\u80bf\u7624\u7a81\u53d8\u8d1f\u8377\u589e\u52a0\uff0c\u8fd9\u4e9b\u56e0\u7d20\u901a\u5e38\u4e0e\u66f4\u5f3a\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u76f8\u5173\u3002\u4f46\u73af\u5883\u81f4\u764c\u7269\u53ea\u662f\u51b0\u5c71\u4e00\u89d2\uff0c\u968f\u7740\u7814\u7a76\u7684\u6df1\u5165\uff0c\u5176\u4ed6\u53ef\u80fd\u5f71\u54cd\u6297\u80bf\u7624\u514d\u75ab\u548c\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u56e0\u7d20\u4e5f\u9010\u6e10\u88ab\u8bc6\u522b\u51fa\u6765\uff0c\u5305\u62ec\u996e\u98df\u3001\u751f\u6d3b\u538b\u529b\u548c\u80a0\u9053\u5fae\u751f\u7269\u7ec4\u7684\u53d8\u5316\u3002\u8fd9\u4e9b\u56e0\u7d20\u4e0d\u4ec5\u5bf9\u76d1\u6d4b\u6cbb\u7597\u53cd\u5e94\u81f3\u5173\u91cd\u8981\uff0c\u800c\u4e14\u5bf9\u4e8e\u4f18\u5316\u6cbb\u7597\u7b56\u7565\u5177\u6709\u6f5c\u5728\u7684\u91cd\u8981\u610f\u4e49\u3002\u8fd1\u671f\u7684\u7814\u7a76\u5f3a\u8c03\u4e86\u80a0\u9053\u5fae\u751f\u7269\u7ec4\u8c03\u8282\u53ef\u4ee5\u5b9e\u9645\u589e\u5f3a\u6cbb\u7597\u53cd\u5e94\u7684\u53ef\u80fd\u6027\uff0c\u76ee\u524d\u5df2\u6709\u4e34\u5e8a\u8bd5\u9a8c\u5728\u8bbe\u8ba1\u4e2d\uff0c\u4ee5\u5229\u7528\u8fd9\u4e9b\u65b0\u89c1\u89e3\u3002\u8fd9\u4e00\u53d1\u73b0\u4e3a\u764c\u75c7\u6cbb\u7597\u5f00\u8f9f\u4e86\u65b0\u7684\u65b9\u5411\uff0c\u5f3a\u8c03\u4e86\u7efc\u5408\u8003\u8651\u5185\u5916\u90e8\u56e0\u7d20\u5bf9\u4e8e\u6210\u529f\u6cbb\u7597\u7684\u91cd\u8981\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.3 \u5f53\u524d\u7684\u548c\u65b0\u51fa\u73b0\u7684\u53cd\u5e94\u3001\u8010\u836f\u6027\u548c\u6bd2\u6027\u9884\u6d4b\u56e0\u7d20<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u4e86\u89e3\u6297\u80bf\u7624\u514d\u75ab\u590d\u6742\u6027\u7684\u57fa\u7840\u4e0a\uff0c\u751f\u7269\u6807\u5fd7\u7269\u7684\u5f00\u53d1\u5df2\u6210\u4e3a\u9884\u6d4b\u6cbb\u7597\u53cd\u5e94\u3001\u8010\u836f\u6027\u548c\u6f5c\u5728\u6bd2\u6027\u7684\u5173\u952e\u5de5\u5177\u3002\u5c3d\u7ba1\u76ee\u524d\u5e38\u7528\u7684\u6807\u5fd7\u7269\u5982PD-L1\u548cCD8\u5728\u4e34\u5e8a\u5e94\u7528\u4e2d\u663e\u793a\u51fa\u4e00\u5b9a\u7684\u9884\u6d4b\u4ef7\u503c\uff0c\u5b83\u4eec\u4ecd\u7136\u5b58\u5728\u5c40\u9650\u6027\uff0c\u5e76\u4e14\u5e02\u573a\u4e0a\u7f3a\u4e4f\u7ecf\u8fc7\u5e7f\u6cdb\u8ba4\u8bc1\u7684\u9ad8\u6548\u751f\u7269\u6807\u5fd7\u7269\u3002\u7136\u800c\uff0c\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u6f5c\u5728\u9884\u6d4b\u56e0\u7d20\u7684\u63a2\u7d22\u548c\u6d4b\u8bd5\u5de5\u4f5c\u4ecd\u5728\u6301\u7eed\u8fdb\u884c\uff0c\u5e76\u4e14\u9884\u6d4b\u56e0\u7d20\u7684\u79cd\u7c7b\u6b63\u5728\u4e0d\u65ad\u589e\u52a0\u3002\u672c\u6587\u5c06\u8be6\u7ec6\u8ba8\u8bba\u8fd9\u4e9b\u6b63\u5728\u7814\u7a76\u4e2d\u7684\u65b0\u5174\u9884\u6d4b\u56e0\u7d20\uff0c\u4ee5\u671f\u63d0\u4f9b\u66f4\u5168\u9762\u7684\u6cbb\u7597\u7b56\u7565\u6307\u5bfc\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.3.1 \u4e34\u5e8a\u53cd\u5e94\u7684\u9884\u6d4b\u56e0\u7d20<\/p>\n<\/section>\n

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\u65e9\u671f\u5173\u4e8e\u68c0\u67e5\u70b9\u6291\u5236\u5242\u836f\u7269\u7684\u4e34\u5e8a\u7ecf\u9a8c\u63ed\u793a\u4e86\u4e00\u79cd\u8d8b\u52bf\uff1a\u9ad8\u75be\u75c5\u9884\u5904\u7406\u8d1f\u62c5\u548c\u5feb\u901f\u75be\u75c5\u8fdb\u5c55\u901a\u5e38\u4e0e\u8f83\u4f4e\u7684\u6cbb\u7597\u54cd\u5e94\u53ef\u80fd\u6027\u548c\u8f83\u5dee\u7684\u751f\u5b58\u7ed3\u679c\u76f8\u5173\u3002\u8fd9\u90e8\u5206\u539f\u56e0\u662f\u7531\u4e8e\u4f7f\u7528\u4f0a\u5339\u5355\u6297\uff08ipilimumab\uff0c\u7b2c\u4e00\u79cd\u88ab\u6279\u51c6\u7528\u4e8e\u764c\u75c7\u6cbb\u7597\u7684\u68c0\u67e5\u70b9\u6291\u5236\u5242\uff09\u65f6\u89c2\u5bdf\u5230\u7684\u5ba2\u89c2\u53cd\u5e94\u6709\u65f6\u4f1a\u5ef6\u8fdf\u51fa\u73b0\uff0c\u4e14\u603b\u4f53\u5ba2\u89c2\u5e94\u7b54\u7387\u8f83\u4f4e\u3002\u4e0e\u57fa\u4e8ePD-1\u901a\u8def\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6216CTLA-4\u548cPD-1\u8054\u5408\u963b\u65ad\u6cbb\u7597\u76f8\u6bd4\uff0c\u540e\u8005\u7684\u5e94\u7b54\u7387\u66f4\u9ad8\uff0c\u53cd\u5e94\u5f00\u59cb\u4e5f\u66f4\u8fc5\u901f\u3002\u7136\u800c\uff0c\u75be\u75c5\u8d1f\u62c5\u663e\u7136\u4ecd\u7136\u53d1\u6325\u7740\u91cd\u8981\u4f5c\u7528\uff0c\u4f8b\u5982\u5728\u4f7f\u7528PD-1\u6291\u5236\u5242\u6d3e\u59c6\u5355\u6297\uff08pembrolizumab\uff09\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\uff0c\u57fa\u7ebf\u75be\u75c5\u8d1f\u62c5\uff08\u901a\u8fc7\u653e\u5c04\u5b66\u8bc4\u4f30\u7684\u635f\u4f24\u786e\u5b9a\uff09\u662f\u603b\u4f53\u751f\u5b58\u7387\u8f83\u4f4e\u7684\u72ec\u7acb\u9884\u540e\u56e0\u7d20\uff0c\u5e76\u4e14\u4e0e\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u8054\u5408\u8d1d\u4f10\u5355\u6297\uff08bevacizumab\uff09\u6cbb\u7597\u7684\u4e00\u90e8\u5206\u60a3\u8005\u7684\u751f\u5b58\u7387\u5f3a\u8d1f\u76f8\u5173\u3002<\/p>\n

\u6b64\u5916\uff0c\u901a\u8fc7RECIST\u6216irRC\u6807\u51c6\u83b7\u5f97\u5e94\u7b54\u7684\u60a3\u8005\u901a\u5e38\u6bd4\u5ba2\u89c2\u65e0\u5e94\u7b54\u7684\u60a3\u8005\u6709\u66f4\u597d\u7684\u957f\u671f\u7ed3\u679c\u3002\u7136\u800c\uff0c\u5176\u4ed6\u57fa\u4e8e\u6210\u50cf\u7684\u6307\u6807\uff0c\u5982\u80bf\u7624\u7684\u5bc6\u5ea6\u548c\u7eb9\u7406\u7279\u5f81\uff0c\u5176\u9884\u540e\u548c\/\u6216\u9884\u6d4b\u4ef7\u503c\u5c1a\u5f85\u8fdb\u4e00\u6b65\u7814\u7a76\uff0c\u53ef\u80fd\u9700\u8981\u4e3a\u4e0d\u540c\u7684\u80bf\u7624\u7c7b\u578b\u548c\u75be\u75c5\u90e8\u4f4d\u5236\u5b9a\u66f4\u4e3a\u590d\u6742\u7684\u8bc4\u4f30\u6807\u51c6\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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31.3.2  \u4ee5\u7ec4\u7ec7\u4e3a\u57fa\u7840\u7684\u53cd\u5e94\u9884\u6d4b\u56e0\u5b50<\/p>\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 | \u6e29\u946b<\/span><\/p>\n

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

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ACIR\u6587\u732e\u901f\u9012<\/span><\/a><\/p>\n

SCI\u8bba\u6587\u4f5c\u56fe<\/span><\/a><\/p>\n

SCI\u8bba\u6587\u5199\u4f5c\u53ca\u6295\u7a3f<\/span><\/a><\/p>\n

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RCIM\u4eea\u5668\u7b80\u4ecb\u53ca\u64cd\u4f5c\u89c6\u9891<\/a><\/span><\/p>\n

\u5e38\u7528\u7535\u8111\u8f6f\u4ef6\u4f7f\u7528\u6559\u7a0b<\/a><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u672c\u7bc7\u6587\u7ae0\u6765\u6e90\u4e8e\u5fae\u4fe1\u516c\u4f17\u53f7:OncoLab<\/p>\n<\/blockquote>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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