杆菌和免疫疗法用于胃肠道癌症
Keren Jia1, Yang Chen1, Yi Xie1
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China.
杆菌感染有利于胃癌的免疫疗法,因为它创造了一个"热"的瘤环境. 然而,它可能会降低免疫治疗在特定结肠直肠和食道癌症的有效性.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 微生物学 微生物学
背景情况:
- 杆菌 (H. pylori) 感染与胃肠道癌症有关,但其在癌症免疫治疗结果中的作用尚不清楚.
- 了解H. pylori的影响对于优化各种胃肠道恶性瘤的免疫治疗策略至关重要.
研究的目的:
- 调查H. pylori感染与不同胃肠道癌症的抗PD-1/PD-L1免疫疗法的疗效之间的关联.
- 探索由H. pylori感染影响的潜在机制,包括瘤微环境特征和分子概况.
主要方法:
- 对10122名接受H. pylori检测 (13C尿素呼吸试验) 的患者进行分析.
- 在接受抗PD-1/PD-L1治疗的患者中,对免疫相关无进展生存 (irPFS) 和免疫相关总生存 (irOS) 的回顾性评估.
- 在胃癌 (GC) 样本中评估瘤免疫细胞透 (PD-L1 +,CD8 + T 细胞) 和转录基因分析.
主要成果:
- 在Epstein-Barr病毒阴性,微卫星稳定的GC中,H. pylori阳性患者显示显著更长的irPFS (6.97 vs 5.03个月) 和更长的irOS趋势相比H. pylori阴性患者.
- H. pylori 阳性 GC 呈现出"热"的瘤微环境,具有较高的 PD-L1+ 细胞和未耗尽的 CD8+ T 细胞密度.
- 相反,H. pylori感染与dMMR/MSI-H结肠直肠腺癌和ESCC中较短的irPFS有关,肝癌和胰腺癌的结果更差的趋势.
结论:
- 杆菌感染似乎是胃癌免疫治疗的有益因素,可能是通过促进有利的瘤微环境.
- 杆菌对免疫治疗疗效的影响因癌症类型和分子亚型而异;在dMMR/MSI-H结肠直肠腺癌和ESCC.中,它可能是有害的.
- 需要进一步的研究来阐明H. pylori在癌症免疫治疗中的复杂作用,并对患者群体进行分层,以选择最佳的治疗方法.
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