脐血造血干细胞对原发性肝细胞癌的抑制作用

Inhibitory effects of umbilical cord blood hematopoietic stem cells on primary hepatocellular carcinoma

背景:原发性肝细胞癌是一种临床常见的恶性肿瘤,虽然近年来各种治疗方式如外科手术、射频消融以及选择性动脉栓塞等治疗方式均取得了进展,但对于某些进展期肝癌患者,这些治疗方法具有一定的局限性。在这样的背景下,干细胞对恶性肿瘤的治疗或抑制作用正逐渐成为人们关注的焦点。目的:对原发性肝细胞癌的发病情况、肿瘤免疫编辑过程、肿瘤微环境以及脐血造血干细胞对原发性肝细胞癌和其他实体肿瘤的抑制作用进行综述。方法:检索万方医药网及外文生物医学期刊数据库2000-01/2010-09有关原发性肝细胞癌发病情况、免疫微环境以及造血干细胞对包括肝细胞癌在内的实体肿瘤抑制作用的文章,中文检索词为"肝癌,造血干细胞,免疫微环境",英文检索词为"hepatocellular carcinoma,hematopoietic stem cell,microenvironment"。最终筛选出33篇文献作进一步分析。结果与结论:肿瘤的发生及发展与机体免疫系统的变化密切相关,在已发生肿瘤的机体内,免疫系统处于抑制状态,对于恶性肿瘤细胞无反应或者低反应。脐血造血干细胞具有免疫原性低、分裂能力强、分化谱系广等特点,在接受移植的机体内能够分化为多种谱系的细胞,其中包括多种免疫细胞,从而弥补机体原有免疫系统的缺陷,起到杀伤肿瘤细胞、抑制肿瘤生长的作用。然而其作用机制、适应证及不良反应等仍需进一步深入研究。

BACKGROUND：Primary hepatocellular carcinoma is a common malignant tumor in clinic.Although various treatment measures such as surgery,radio frequency ablation,selective arterial embolization have made progresses,these treatments are not suitable for a few patients who suffered from advanced hepatocellular carcinoma.Under such circumstances,more researchers are concerned with the therapeutical or inhibitory effects of stem cells on malignant tumors.OBJECTIVE：To review incidence,immunoediting process,microenvironment of primary hepatocellular carcinoma and suppressive effect of hematopoietic stem cells on it or other solid malignant tumors.METHODS：Computer-based online search of Wanfang database and Foreign Medical Journal full-text Service database was performed for literatures concerning incidence,immune microenvironment of primary hepatocellular carcinoma and suppressive effect of hematopoietic stem cells on solid malignant tumors including hepatocellular carcinoma published between January 2000 and September 2010.The Key words were ＂hepatocellular carcinoma,hematopoietic stem cell,microenvironment＂.Finally,33 literatures were included.RESULTS AND CONCLUSION：Occurrence and development of the tumor closely associated with changes in the body immune system.In the body with a tumor,the immune system is under inhibitory state,and has no response or low response to malignant tumor cells.Umbilical cord blood hematopoietic stem cells were characterized by low immunogenicity,strong fission ability and wide differentiation lineage.Umbilical cord blood hematopoietic stem cells can differentiate into various lineages of cells in the body following transplantation,including many immune cells,which can supplement the defects of the immune system,and kill tumor cells,and inhibit tumor growth.However,its action mechanism,indication and adverse effect need more explorations.