肿瘤微环境对蕈样肉芽肿生物学行为的影响

Effects of tumor microenvironment on biological behavior of mycosis fungoides

蕈样肉芽肿是原发于皮肤的、具有独特临床表现、组织病理、免疫表型和遗传特征的皮肤T细胞淋巴瘤。蕈样肉芽肿肿瘤微环境由肿瘤细胞、局部浸润的免疫细胞、间质细胞及其所分泌的细胞因子等组成。树突细胞（包括朗格汉斯细胞）在蕈样肉芽肿发展的不同阶段发挥着双向作用，成熟树突细胞介导了抗肿瘤免疫反应，未成熟树突细胞诱导了免疫耐受反应。调节性T细胞与Th17细胞的功能失衡也决定了蕈样肉芽肿的进程，细胞因子特别是趋化因子在蕈样肉芽肿亲表皮现象中发挥重要作用，白介素10导致局部免疫抑制与蕈样肉芽肿预后密切相关。肿瘤微环境的改变决定了蕈样肉芽肿的病程发展规律与生物学行为。

Mycosis fungoides （MF） is a T-cell lymphoma originating in the skin with distinct clinical and histopathologlcal manifestations, immunophenotype, and genetic features. The tumor microenvironment in MF consists of tumor ceils, locally infiltrating immune cells, mesenchymal cells and cytokines secreted by these cells. Dendritic cells （DCs）, including Langerhans cells, perform a dual role in the development of MF. It is considered that mature DCs mediate anti-tumor immune response, while immature DCs induce tumor tolerance. The balance between the function of regulatory T cells and T helper 17 cells also affects the progression of MF. Cytokines, especially chemokines, play an important role in the epidermotropism in MF, and interleukin 10 has an impact on the prognosis of MF via inducing local immunosuppression. Therefore, tumor microenvironment determines the unique course and biological behavior of MF.