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肝癌免疫治疗的研究进展和临床展望
王正,王明达,李镇利,杨田*
0
(第二军医大学东方肝胆外科医院肝胆外科, 上海 200438
*通信作者)
摘要:
原发性肝癌是全球发病率最高的恶性肿瘤之一。中国是肝癌大国,全世界一半以上的肝癌发生在中国。生物免疫治疗近年来受到了广泛关注,其在某些实体恶性肿瘤中发挥了显著的疗效,而针对肝癌的免疫治疗也已取得了一些基础研究和临床研究的进展。肝癌免疫治疗的治疗方案主要包括过继性免疫治疗、间接免疫性治疗、间接非免疫性治疗。尽管肝癌免疫治疗有望最终彻底消灭肝癌,但目前仍存在许多难题和挑战,如肝脏所特有的免疫抑制状态以及缺乏较理想的抗原靶标等。因此,要将生物免疫治疗真正应用到肝癌的临床实践中,依然任重而道远。
关键词:  肝肿瘤  肝细胞癌  免疫疗法  发病机制  抗原靶标  程序性死亡因子1  程序性死亡因子配体1
DOI:10.16781/j.0258-879x.2017.08.0953
投稿时间:2017-06-08修订日期:2017-07-10
基金项目:国家自然科学基金(81472284,81672699),上海市浦江人才项目(16PJD004).
Immunotherapy for hepatocellular carcinoma: research advances and clinical prospects
WANG Zheng,WANG Ming-da,LI Zhen-li,YANG Tian*
(Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
*Corresponding author)
Abstract:
Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed malignancies and the third leading cause of cancer-related deaths in the world. China is known as "the country with the highest prevalence of liver cancer", and more than half of the cases of HCC worldwide occur in China. Recently, immunotherapy for HCC has drawn wide attention owing to its satisfying effects on specific solid malignancies. Both basic and clinical researches on immunotherapy for HCC have made some progress, which has laid a foundation for future clinical application of immunotherapy in HCC patients. The main immunological strategies for HCC include adoptive immunotherapy, indirect immunotherapy, and indirect non-immunological therapy. Despite the potential benefits for HCC, challenges and obstacles of immunotherapy remain, such as the self-tolerance immune mechanism of the liver and the lack of ideal target antigen. In a word, the application of immunotherapy for HCC in clinical practice is a tough task to accomplish and a long way to go.
Key words:  liver neoplasms  hepatocellular carcinoma  immunotherapy  pathogenetic mechanism  antigen target  programmed cell death-1  programmed cell death-1 ligand