冷冻消融结合免疫治疗:实现抗肿瘤效应最大化

Cryoablation Combined with Immunotherapy:Maximizing Anti-Tumor Effects

近年来,基于能量治疗的肿瘤消融技术应用愈加广泛。其中,冷冻消融技术是通过对探针的快速冷却,有效破坏肿瘤组织。然而,留在原位的肿瘤碎片还会释放出大量抗原,激活免疫细胞,诱导产生抗肿瘤免疫反应。但因冷冻消融参数条件设置的不同,会影响所触发的免疫反应,且因诱发产生的免疫反应的强度和可持续性不足,难以有效抑制肿瘤的复发和转移瘤的生长。综述冷冻消融治疗肿瘤的机制,包括直接细胞损伤、血管损伤和免疫调节,其中免疫调节对肿瘤治疗的良好预后产生重要影响;阐述影响免疫调节效果的冷冻消融因素,探寻冷冻消融治疗后产生免疫反应的最佳条件;概述冷冻消融联合免疫治疗的研究进展,并且探讨联合抗肿瘤治疗的新策略。

In recent years,energy therapy-based tumor ablation techniques have become more widely used.Among them,the cryoablation technique can effectively destroy tumors by rapid cooling of the probe,and the tumor mass left in situ would release a lot of antigens to activate immune cells,inducing the generation of antitumor immune responses.However,the immune response triggered by cryoablation is subjected to its conditional setting,and the intensity and sustainability of the immune response are insufficient to suppress tumor recurrence and the growth of metastases.Hence,this review focuses on the mechanisms of cryoablation for tumors,including direct cell injury,vascular injury,and immunomodulation,in which immunomodulation has a significant impact on the favorable prognosis of tumor therapy.Cryoablation factors affecting immune efficacy were further introduced to discuss the optimal conditions for generating immune response after treatment.The research progress of cryoablation combined with immunotherapy is summarized to propose new strategies for tumor treatment.