摘要
宫颈癌是全球女性常见的恶性肿瘤之一,与持续的高危型人乳头瘤病毒(HPV)感染密切相关。本文综述了宫颈癌的病理机制、T细胞免疫应答的作用与挑战,以及免疫检查点抑制剂(ICIs)在宫颈癌治疗中的应用和缺陷。研究表明,有效的T细胞免疫反应对于控制HPV感染和防止癌症的发展至关重要。然而,HPV蛋白(E6、E7、E5)通过干扰干扰素产生、降低T细胞活性和浸润,以及抑制抗原呈递系统,促进了免疫逃逸。因此,本文探讨了PD-1/PD-L1和CTLA-4免疫检查点在宫颈癌免疫应答中的关键作用,强调了TIM-3蛋白在表观遗传调控中的作用以及与宫颈癌预后的相关性。此外,本文还回顾了ICIs在宫颈癌治疗中的应用,包括单药疗法和双特异性抗体(BsAbs)的组合疗法,以及与之相关的不良反应和管理策略。这些发现揭示了宫颈癌治疗的新方向,并强调了在未来研究中探索个体化和精准医疗策略的重要性。
Cervical cancer is one of the most common malignant tumors in women worldwide, and it is closely related to persistent high-risk human papillomavirus (HPV) infection. This article reviews the pathological mechanisms of cervical cancer, the role and challenges of T-cell immune responses, and the application and limitations of immune checkpoint inhibitors (ICIs) in the treatment of cervical cancer. Studies have shown that effective T-cell immune responses are crucial for controlling HPV infection and preventing the development of cancer. However, HPV proteins (E6, E7, E5) promote immune escape by interfering with interferon production, reducing T-cell activity and infiltration, and inhibiting the antigen presentation system. Therefore, this article explores the key roles of PD-1/PD-L1 and CTLA-4 immune checkpoints in the immune response of cervical cancer, empha-sizing the role of TIM-3 protein in epigenetic regulation and its correlation with the prognosis of cervical cancer. Additionally, this article reviews the application of ICIs in the treatment of cervical cancer, including monotherapy and the combination therapy with bispecific antibodies (BsAbs), as well as related adverse reactions and management strategies. These findings reveal new directions in the treatment of cervical cancer and emphasize the importance of exploring personalized and precision medical strategies in future research.
出处
《临床医学进展》
2024年第1期307-312,共6页
Advances in Clinical Medicine
