病理学在免疫疗法和向治疗细胞癌中的作用
Giuseppe Nicolò Fanelli1,2,3, Giandomenico Roviello4, Gabriella Nesi5
1Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa.
Current opinion in urology
|November 30, 2025
概括
针对细胞癌 (RCC) 的个性化治疗需要整合病理学,免疫类型和分子数据. 像液体活检和人工智能辅助病理学这样的先进工具正在出现,以改进精确瘤学,以获得更好的患者结果.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 基因组学就是基因组学.
背景情况:
- 细胞癌 (RCC) 的全身治疗已经从细胞因子演变为针对VEGF的氨酸激酶抑制剂 (TKI) 和免疫检查点抑制剂 (ICI).
- 尽管存活率有所提高,可靠的免疫疗法和RCC中TKI的可靠预测生物标志物仍然是一个重要的未满足需求.
- 目前的生物标志物如PD-L1表达具有有限的临床实用性,因为在PD-L1阳性和阴性瘤中观察到对ICI的反应.
研究的目的:
- 概述一种病理驱动的框架,用于细胞癌 (RCC) 的个性化治疗策略.
- 整合形态学,免疫类型和分子分析,以引导免疫疗法和TKI治疗.
- 突出病理学和分子诊断在推进RCC精密瘤学的不断变化的作用.
主要方法:
- 对RCC系统治疗,生物标志物和诊断工具的当前文献的审查.
- 整合了形态,免疫类型和分子数据,以形成一个全面的框架.
- 讨论新兴技术,如液体活检,空间转录学和人工智能辅助病理学.
主要成果:
- 虽然PD-L1表达具有生物学相关性,但其在RCC中对ICI反应的预测价值有限.
- 瘤微环境特征和基因组变化 (例如,PBRM1,BAP1,SETD2) 提供预后见解,但具有不一致的预测价值.
- 准确的组织学分类,分级和病理学不良特征的评估对于RCC管理至关重要.
结论:
- 病理学仍然是准确的RCC分类和预后的基础.
- 对非清晰细胞RCC亚型来说,分子分析越来越重要,指导向治疗 (例如,MET驱动的乳头RCC).
- 新兴的工具有望进行最少的侵入性监测,精细的免疫分析和多参数生物标志物集成,以推进RCC的精确瘤学.
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