调控固有免疫防治肺癌转移的研究进展

Research progress of regulating innate immunity in prevention and treatment of lung cancer metastasis

远处转移是导致肺癌患者死亡的重要原因之一,肺癌转移的整体防控效率亟待提高。基于适应性免疫调控为主的免疫靶向治疗已经在晚期肺癌实现疗效的突破,充分证实了免疫编辑理论指导临床的重要价值,但对早期根治术后的远处转移的防治仍缺乏高水平临床证据,提示肺癌转移的发生有适应性免疫之外的机制。因此,本文聚焦探讨固有免疫紊乱与远处转移发生的关系,讨论了NK细胞、巨噬细胞、中性粒细胞、树突状细胞等固有免疫细胞与肿瘤细胞间的作用机制,调控固有免疫细胞防治肺癌转移的临床应用以及固有免疫细胞作为生物标志物丰富转移评估体系的价值。将固有免疫紊乱融合入肺癌转移的核心机制,创新提出“正虚伏毒”学说并构建转移特异性研究平台以探索免疫细胞间、免疫细胞与肿瘤细胞间的作用机制,寻找防治肺癌转移的关键靶点群,研发综合免疫疗法促进肺癌转移防控效率的提高。

Recurrence and metastasis are crucial clinical events leading to mortality in patients with lung cancer.The overall efficiency of prevention and control of lung cancer metastasis needs to be improved.The breakthrough in advanced lung cancer treatment achieved by immune-targeted therapy based on regulation of adaptive immunity fully confirms the clinical importance of immune editing in clinical guidance.However,there is still a lack of high-level clinical evidence for prevention and treatment of distant metastasis after early radical surgery,suggesting that lung cancer metastasis may have an alternative mechanism other than adaptive immunity.Therefore,this review focuses on the relationship between innate immune disorder and occurrence of distant metastasis.We further discuss the interaction between tumor cells and various innate immune cells such as NK cells,macrophages,neutrophils and dendritic cells,as well as the clinical applications of innate immune cell regulation in the prevention and treatment of lung cancer metastasis,including the role of innate immune cells as biomarkers to enrich the metastasis evaluation system.It links innate immune disorder to lung cancer metastasis and puts forward the theory of"hidden toxicity due to vital qi deficiency,"facilitating the establishment of a specific research platform to explore the interaction between immune cells and tumor cells for identifying key targets for the prevention and treatment of lung cancer metastasis and to develop comprehensive immunotherapy to improve the prevention and control efficiency of lung cancer metastasis.