Cancer immunology--analysis of host and tumor factors for personalized medicine.
Cancer immunology--analysis of host and tumor factors for personalized medicine.
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DOI：
10.1038/nrclinonc.2011.122
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发表时间：
2011-08-09
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癌症是一种以细胞生长、侵袭和转移不受控制为特征的疾病。肿瘤微环境中的免疫细胞在调节肿瘤进展中具有重要作用。刺激对肿瘤的免疫反应是有吸引力的治疗和预防策略。癌细胞和宿主非转化细胞在肿瘤微环境中不断相互作用。因此，癌症免疫学是一个跨学科的领域，其中宿主和肿瘤因素的综合分析是必不可少的。然而，大多数以往的抗肿瘤免疫和临床结局的研究缺乏对肿瘤分子生物标志物的分析。由于癌症代表了具有不同遗传和表观遗传改变集合的异质性疾病组，因此癌症的分子分类（例如，肺癌、胰腺癌、前列腺癌和乳腺癌）已经成为临床决策的重要组成部分。在这篇综述中，我们将结肠直肠癌作为癌症的典型例子进行讨论。结肠癌的常见分子分类包括KRAS、BRAF和PIK 3CA癌基因突变、微卫星不稳定性（MSI）、LINE-1甲基化和CpG岛甲基化表型（CIMP）;每种特征均构成潜在的预后或预测生物标志物。由于肿瘤分子特征和免疫反应是相互关联的，因此对这些因素进行综合评估至关重要。事实上，MSI和CIMP可能与抗肿瘤免疫应答有因果关系。研究肿瘤-宿主相互作用对临床结果和预后的影响代表了分子病理流行病学（MPE）的一个不断发展的跨学科领域。病理学实践中的免疫评估可以提供预后信息，并帮助确定更有可能从免疫治疗中受益的患者。
Cancer is a disease characterized by the uncontrolled cellular growth, invasion and metastasis. Immune cells in the tumor microenvironment have an important role in regulating tumor progression. Stimulating immune reactions to tumors are attractive therapeutic and prevention strategies. Cancer cells and host non-transformed cells constantly interact with each other in the tumor microenvironment. Thus, cancer immunology is an interdisciplinary area where integrated analysis of both host and tumor factors is essential. However, most previous studies on anti-tumor immunity and clinical outcome lack analysis of tumor molecular biomarkers. Because cancer represents a heterogeneous group of diseases with different sets of genetic and epigenetic alterations, molecular classification of cancer (e.g., lung, pancreas, prostate, and breast cancers) has become an important component in clinical decision-making. In this Review, we discuss colorectal cancer as a prototypical example of cancer. Common molecular classifiers of colon cancer include KRAS, BRAF and PIK3CA oncogene mutations, microsatellite instability (MSI), LINE-1 methylation, and CpG island methylator phenotype (CIMP); each feature constitutes a potential prognostic or predictive biomarker. Since tumor molecular features and immune reactions are interrelated, a comprehensive assessment of these factors is critical. In fact, MSI and CIMP may causally link to anti-tumor immune response. Examining effects of tumor-host interactions on clinical outcome and prognosis represent an evolving interdisciplinary field of molecular pathological epidemiology (MPE). Immunity evaluation in pathology practice may provide information on prognosis and help identify patients who are more likely to benefit from immunotherapy.