肝癌的免疫治疗进展  

Immunity therapies in hepatocellular carcinoma

作　　者：黎可人 孙诚谊 LI Ke-ren;SUN Cheng-yi(Department of Hepatobiliary Surgery,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,P.R.China;Hepatobiliary and Pancreatic Ney Laboratory of Guizhou Medical University,Guiyang 550004,P.R.China)

机构地区：[1]贵州医科大学附属医院肝胆外科,贵州贵阳550004 [2]贵州医科大学肝胆胰脾重点实验室,贵州贵阳550004

出　　处：《中华肿瘤防治杂志》2018年第17期1266-1270,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：贵州省高层次创新人才培养计划"十"层次人才[黔科合平台人才(2016)5647];贵州省孙诚谊"肝胆胰脾疾病诊治"导师工作室[黔教研合GZS(2016)09];贵州省肝胆外科临床医学研究中心[黔科合平台人才(2017)5404]

摘　　要：目的近年来,随着生物治疗技术的发展,免疫治疗已成为目前肿瘤治疗领域的热点,医学界对其治疗效果给予很高的期望,本研究总结分析最近几年免疫治疗在肝癌治疗方面取得的进展,及免疫治在肝癌治疗中的应用及临床效果。方法应用PubMed及中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)检索系统,以"肝细胞癌、免疫治疗、进展、免疫检查点抑制剂、程序性死亡分子(programmed death 1,PD-1)/程序性死亡配体-1(programmed death-ligand 1,PD-L1)、T淋巴细胞相关抗原-4(cytotoxic T lymphocyte associated antigen-4,CTLA-4)"等为关键词,检索2015-04-2018-04的相关文献,共220篇英文文献和90篇中文文献。纳入标准:(1)免疫治疗在肝细胞癌中的进展;(2)免疫检查点阻滞剂在肿瘤免疫治疗中的应用;(3)PD-1/PD-L1在肝细胞癌治疗中的研究进展;(4)靶向治疗联合免疫治疗在肝癌治疗中的应用。根据纳入标准,分析文献38篇。结果随着分子生物学和分子免疫学的迅速发展,免疫治疗已开始应用于肝细胞癌的治疗中。这些治疗通过打破肿瘤产生的免疫抑制,恢复机体的抗肿瘤能力,并且免疫治疗与传统的手术治疗、靶向治疗及全身性系统化疗相结合,有效地延长了肿瘤进展时间及总生存期,并有较高的疾病控制率。但是,由于未能找到理想的相关抗原靶点,免疫治疗在肝癌方面未取得突破性的进展,尚未取代传统的治疗方式,但根据其特有优势,可成为传统治疗方式的辅助治疗。结论免疫治疗在肝癌治疗中虽不能取代传统治疗方式,但根据其自身特异性高、毒副作用小的特点,可成为肝癌的辅助治疗。OBJECTIVE In recent years,with the development of biotherapeutic technology,irnmunotherapy has be- come a hot spot in the field of cancer treatment. This study aimed to analyze the progress in the treatment of liver cancer with immunotherapy in recent years and summarize the application and clinical effects of various methods in the treatment. METHODS The keywords such as ＂hepatocellular careinoma, immunotherapy, progression, immune checkpoint inhibi tors,PD-1/PD-L1,CTLA-4＂,were used to retrieve relevant documents from April 2015 to April 2018 in PubMed and CNKI full-text databases,including 220 English articles and 90 Chinese articles. The inclusion criteria includes： （1）pro gress of Immunotherapy in Hepatocellular Carcinoma; （2）application of immune checkpoint blockers in tumor immuno- therapy;（3） the progress of PD-1/PD-L1 in the treatment of hepatoeellular carcinoma; （4）application of targeted therapy combined with immunotherapy in the treatment of liver cancer. According to the inclusion criteria, there were 39 articles meet the criteria. RESULTS With the rapid development of molecular biology and molecular immunology,immunotherapy has been used in the treatment of hepatocellular carcinoma. These treatments can not only restore the body＇s anti-tumor a- bility by breaking the immune suppression produced by the tumor,but also can be combined with traditional treatments, improving the overall survival and prolong the time to tumor progression. However, immunotherapy failed to achieve breakthrough results in liver cancer due to the failure of finding ideal target for related antigens and hence hasn＇t replacedtraditional treatments. It can be an adjunct to traditional treatments according to its unique advantages. CONCLUSION Al- though immunotherapy can not replace the traditional treatment,it can be an effective adjuvant therapy.

关 键 词：原发性肝癌 免疫抑制 免疫治疗 PD-1/PD-L1 联合治疗 综述文献 

分 类 号：R735.7[医药卫生—肿瘤]