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@#[摘 要] PD-1/PD-L1抑制剂在乳腺癌免疫治疗中的应用已逐渐成为一种重要的治疗手段，然而对乳腺癌，尤其是三阴性乳腺癌（TNBC）的免疫治疗仍存在某些亟待解决的科学问题，包括PD-1/PD-L1抑制剂单药治疗的有效率欠佳，目前尚无明确的生物标志物来有效筛查治疗敏感人群，免疫相关不良反应（irAE）的发生率高。为了提高疗效和减少irAE的发生，采取以下措施是非常重要的：探讨PD-1/PD-L1抑制剂与其他药物的联合应用方案；采用纳米技术开发选择性靶向肿瘤细胞的纳米载体，降低抗肿瘤药物毒性并提高疗效；探寻开发可预测免疫治疗反应潜力的生物标志物；早期识别和诊疗irAE并建设多学科诊疗协作组（MDT）模式。随着这些措施的积极推进和问题的不断解决，PD-1/PD-L1抑制剂在乳腺癌的治疗中必将呈现出更为广阔的应用前景。
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@#[Abstract] Objective: To investigate the expression of human endogenous retrovirus subfamily H long terminal repeat associating protein 2 (HHLA2) in hepatocellular carcinoma (HCC) tissues and its correlation with the clinicopathological characteristics and prognosis of patients with HCC. Methods: Based on TCGA database, the correlation between HHLA2 mRNA expression and B7 family genes in human HCC tissues was analyzed. HHLA2 expression in 90 pairs of HCC tissues and their adjacent tissues was detected by tissue microarry and immunohistochemical staining. Wilcoxon rank sum test was used to compare the difference of HHLA2 expression between HCC tissues and its adjacent tissues. The chi-square test was used to analyze the relationship between HHLA2 expression in human HCC tissues and clinicopathological features of the patients. Kaplan-Meier survival analysis was performed to analyze the correlation between HHLA2 expression and patients’ overall survival (OS), and the Cox model was used to evaluate the prognostic value of different indices. Results: The expression level of HHLA2 mRNA in HCC tissues was correlated with B7 family CD274, C10orf54, PDCD1LG2, ICOSLG and CD276. The expression level of HHLA2 in HCC tissues was significantly correlated with tumor size (χ2=4.531, P<0.05). The OS of HCC patients with high HHLA2 expression was significantly shorter than that of the patients with lower HHLA2 expression (HR=1.878, 95%CI: 1.066-3.309, P<0.05). The COX model showed that tumor size (HR=2.493, 95%CI: 1.310-4.742, P<0.01) could be used as an independent risk factor for the prognostic prediction of the patients. Conclusion: HHLA2 is significantly correlated with the prognosis of HCC patients, and can be used as a potential target for HCC immunotherapy.
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@#[Abstract] Objective: To investigate the expression of chemokine-like factor-like MARVEL transmembrane domain-containing family member 6 (CMTM6) in breast cancer tissues and its correlation with clinicopathological features and prognosis of patients. Methods:Atotal of 136 breast cancer tissue chips (purchased from Superchip Company), including 42 pairs of matched cancer and paracancerous tissues, were used for this study. The expression level of CMTM6 in cancer and paracancerous tissues was detected by immunohistochemistry. The comparison of CMTM6 expression between breast cancer and paracancerous tissues was conducted by paired χ2 test. The relationship between CMTM6 expression in breast cancer tissues and the clinicopathological characteristics of patients was analyzed by χ2 test. Kaplan-Meier and Log rank test analyses were used to analyze the relationship between CMTM6 expression and the survival of patients, and Cox model was used to evaluate the effect of different indicators on the prognosis of patients. Results: The expression of CMTM6 in breast cancer tissues was significantly higher than that in paracancerous tissues (P<0.01). The expression of CMTM6 was correlated with pathological type of breast cancer and HER2 positivity (P<0.05). The survival time of patients in CMTM6 high expression group was significantly shorter than that of patients in CMTM6 low expression group (P<0.05). Pathological type (HR=10.374, 95%CI: 3.529-30.497, P<0.01), TNM stage (HR=4.599, 95%CI: 1.784-11.856, P<0.01), triple-negative breast cancer (HR=3.370, 95%CI: 1.055-10.761, P<0.05) and high expression of CMTM6 (HR=0.195, 95%CI: 0.073-0.518, P<0.01) were independent risk factors for prognosis of breast cancer patients. Conclusion: CMTM6 is highly expressed in breast cancer tissues, which can be used as a risk factor for prognosis evaluation of breast cancer patients.
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@# Objective: To evaluate the expression of CKLF-like MARVEL transmembrane domain containing member 6 (CMTM6) in lung adenocarcinoma tissues, and to explore its correlation with the clinicopathologic features and prognosis of patients. Methods: Eighty-six pairs of cancer tissues and para-cancer tissues from patients that pathologically confirmed with lung adenocarcinoma were collected during September 2004 and June 2009 at the Third Affiliated Hospital of Soochow University. The expression levels of CMTM6 in above mentioned tissues were detected by immunohistochemistry. Serum of 52 patients with confirmed lung adenocarcinoma was collected before and after surgery, and serum of 32 healthy subjects was also collected. The levels of CMTM6 and PD-L1 in peripheral blood before and after surgery were measured and analyzed by ELISA. Chi-square test was used to analyze the relationship between CMTM6 expression and clinicopathological features; Kaplan-Meier method and Log-Rank test were used to analyze the survival data of patients. Results: CMTM6 was widely expressed in lung adenocarcinoma tissues; 30% of the tumor tissues showed an up-regulation as compared with para-cancer tissues, and 70% showed no difference. CMTM6 expression was associated with clinical stage and distant metastasis (all P<0.05), but not significantly associated with age, gender, tumor size, and T stage (P>0.05). Kaplan-Meier survival analysis showed the survival rate of patients with high CMTM6 expression was significantly lower than those with stable expression (P=0.014), and among patients at stage Ⅲ, the survival rate of patients with high CMTM6 expression was significantly lower than those with stable CMTM6 expression (P=0.001). Cox regression model analysis of multiple factors showed CMTM6 expression was an independent risk factor for the prognosis of patients with lung adenocarcinoma. CMTM6 expression in pre-surgery serum, post-surgery serum and healthy donors’serum showed statistically significant differences (P<0.05), which was significantly correlated with tumor size and age of the patients. Spearman correlation analysis showed a significant correlation between serum CMTM6 and PD-L1 expression level (r=0.623, P<0.01). Conclusion: CMTM6 is an independent risk factor for the prognosis of lung adenocarcinoma patients. It plays an important role in the occurrence and development of lung adenocarcinoma and it is a potential tumor suppressor gene.
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@# Chimeric antigen receptor modified T (CAR-T) cell therapy is one of the important methods of tumor immunotherapy. The targeting, killing, proliferation and persistence of CAR-T cells are significantly enhanced than that of conventional T cells.After continuous improvement and evolution, CAR-T cell treatment has achieved excellent progress in hematological tumors and has received extensive attention. However, neurotoxicity arising from the treatment, also known as CAR-T cell relevant encephalopathy syndrome (CRES), has affected its clinical application. Exploring the pathogenesis of CRES and high-risk factors, and finding appropriate strategies is therefore critical for the prevention and treatment of CRES. Here, we take CD19-CAR-T cell treatment as example to review the symptoms and pathogenesis of CRES, discuss high-risk factors as well as coping strategies, in an effort to provide a reference for clinical treatment.
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@#磷脂酰肌醇蛋白聚糖3(glypican-3，GPC3)是一种锚定在细胞膜上的硫酸乙酰肝素(heparan sulfate，HS)蛋白多糖的家族成 员之一。GPC3激活经典的Wnt/β-连环蛋白(β-catenin)途径在肝癌(hepatocellular carcinoma，HCC)中表现出促癌基因的作用。尽 管GPC3在胎肝中含量丰富，在多种实体肿瘤中高表达，然而在成人正常组织中含量极少。选择靶点是肿瘤免疫治疗的关键。迄 今为止靶向GPC3的MRI、PET和近红外成像已被用于早期HCC检测。针对GPC3+实体瘤也已经开发了各种免疫治疗方案，一种 是基于抗GPC3抗体包括单克隆抗体、多肽疫苗、免疫毒素、双特异性抗体等，一种是靶向GPC3的CAR-T/NK疗法，其中部分已 进入I/II期临床试验。靶向GPC3有可能为实体瘤治疗提供新的工具。本文概述GPC3的结构、功能等生物学特性，介绍基于抗 GPC3抗体、CAR-T细胞开发的新策略，提供GPC3免疫疗法靶向实体瘤的证据。
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@#调节性T（regulatory T，Treg）细胞是一类控制体内免疫反应性的T细胞亚群，在维持机体的免疫系统稳态和调节免疫 应答方面具有重要作用，并且发现在多种肿瘤类型中以较高比例存在，被认为是产生抗肿瘤免疫应答的主要障碍。Treg细胞在 其功能状态和稳定性方面存在异质性，通过多种机制发挥免疫负调控作用，目前在自身免疫和肿瘤免疫的研究中发现，特异性调 节不同Treg细胞群体可改善免疫疗效。但是，如何更加合理有效的以Treg细胞为靶点抑制肿瘤的进展仍需进一步探索。本文就 Treg细胞在肿瘤免疫中的作用机制及治疗应用新策略展开综述。
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@# CMTM家族作为一个新的基因家族，在免疫、生殖等系统以及多种肿瘤的发病机制中起到重要作用。CMTM家族中， CMTM1可影响细胞增殖，导致肿瘤发生；与非小细胞肺癌（NSCLC）患者的化疗耐药和预后有关。CMTM2通过AP-1、CREB通 路一定程度上影响HIV-1转录，同时在男性生殖系统中起重要作用。CMTM3等位基因失活或甲基化使其丧失对细胞增殖的负 性调控能力，是胃癌独立的预后指标。CMTM4调控细胞周期影响肿瘤细胞增殖，通过对PD-L1的协同保护参与免疫逃逸。 CMTM5在许多肿瘤中沉默表达，参与肿瘤发生发展相关的信号通路。CMTM6协同PD-L1参与免疫逃逸，是潜在的免疫治疗靶 点。CMTM7在NSCLC中通过Rab5控制EGFR-AKT信号影响肿瘤发展，且与胃癌发展相关。CMTM8通过MARVEL区域影响 EGFR和相关信号通路，调控细胞增殖、分化和凋亡等。上述重要发现，为研究肿瘤的发生发展及肿瘤基因治疗提供了新思路。
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@#Objective: To investigate the degree and distribution of tissue-resident CD8+ T cell (CD103+CD8+T cells) infiltration in colorectal cancer (CRC) tissues, and to analyze its relationship to patients’clinicopathological features and prognosis. Methods: Tissue chips of 88 cases of colon cancer tissues (No.HColA180Su14) and 77 cases of rectal cancer tissues (No. HRec-Ade180Sur-03) were obtained from Shanghai Outdo Biotech Co.,Ltd. Immunofluorescence staining was performed to examine the infiltration pattern and degree of CD103+CD8+T cells in the collected CRC tissues and their para-cancerous tissues. Wilcoxon rank test was used to compare CD103+CD8+T cell infiltration degree in CRC tissues and the para-cancerous tissues. Chi-square test was used to analyze the relationship between CD103+CD8+T cell infiltration in CRC and patients’clinicopathological features. Kaplan-Meier survival analysis was conducted to explore the correlation between CD103+CD8+T cell infiltration and patients’prognosis. Cox model was applied to analyze the correlation between different clinical parameters and patients’prognosis. Results: CD103+CD8+T cell infiltration presented no signifi ·cant differences between CRC and para-cancer tissues (P>0.05). Patients with distant metastasis had significantly lower CD103+CD8+T cell infiltration rate than patients without distant metastasis (P<0.01). There was no significant correlation between the infiltration of CD103+CD8+T cells and other clinicopathological features (P>0.05). Kaplan-Meier survival analysis showed that the overall survival (OS) of patients with high CD103+CD8+T cell infiltration was significantly longer than that of the patients with low infiltration (54.42% vs 25.00%, P<0.05). Multivariate Cox model analysis indicated that pathological grade (P<0.01) and high CD103+CD8+T cell infiltration (P<0.05) were independent prognostic factors for CRC. Conclusion： ：CD103+CD8+T cell infiltration in CRC is associated with patients’prognosis, suggesting that CD103+CD8+T cell plays an important role in the initiation and development of CRC.
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@# Chimeric antigen receptor modified T (CAR-T) cell, a novel adoptive immunotherapy strategy, has been used successfully against hematological tumors. However, in solid tumors, due to multiple immunosuppressive cells, immunosuppressive molecules, and extracellular matrix play a suppressive role in the cytotoxic effects of migrating CAR-T cells and severely inhibit the antitumor efficacy of CAR-T cells in the tumor microenvironment of solid tumors. Simultaneously, tumor heterogeneity, lacking proper tumor antigens, poor homing ability at solid tumor sites, along with off-target effect, resulting in poor therapeutic effect of CAR-T cells in solid tumors. Compared with hematological tumors, solid tumors have complex biological characteristics, and thus targeted strategies are demanded to ensure long-term efficacy of CAR-T cells against tumors. This review makes a summary of the development of CAR-T cells, the confusion in solid tumors and the progress of treatment strategies.