Background:The cyclin-dependent kinase inhibitor 2a(CDKN2A)gene,identified as the multiple tumor suppressor gene,functions as a regulatory gene implicated in cancer pathogenesis.Its significance lies in its pivotal in...Background:The cyclin-dependent kinase inhibitor 2a(CDKN2A)gene,identified as the multiple tumor suppressor gene,functions as a regulatory gene implicated in cancer pathogenesis.Its significance lies in its pivotal involvement in the genesis of various tumors;notwithstanding,the precise connection between CDKN2A and c olon adenocarcinoma(COAD)remains undisclosed.Methods:The objective of this research was to assess the predictive importance of CDKN2A in COAD by analyzing data from The Cancer Genome Atlas database.Logistic regression,signed rank test,Wilcoxon test,and Kruskal-Wallis test were used to examine CDKN2A expression levels and clinicopathological features.Univariate and multivariate Cox r egression analyses and Kaplan-Meier analysis found prognostic variables.Additionally,gene set enrichment analysis identified key CDKN2A expression pathways.The study additionally examined CDKN2A expression with tumor immune infiltration using The Cancer Genome Atlas data and single sample gene set enrichment analysis.Results:The results of this investigation indicated a substantial connection between higher CDKN2A expression and negative outcomes in terms of overall survival and disease-related survival among COAD patients.Gene set enrichment analysis indicated a tight link between CDKN2A and both the cell cycle and hedgehog signaling pathways.Subsequent evaluation employing single sample gene set enrichment analysis demonstrated a positive link between CDKN2A expression with infiltration by iDCs,whereas a negative correlation was detected with infiltration by helper T cells.Conclusion:In conclusion,the present study gives strong data supporting the predictive value of CDKN2A and its possible usefulness as a biomarker for COAD.Additionally,our results show a reasonable link between CDKN2A expression and immune influx in COAD,putting light on the role of CDKN2A in the control of the tumor microenvironment.Nevertheless,additional studies are needed to confirm the underlying mechanisms of these relationships and to discover the therapeutic possibilities of targeting CDKN2A in the treatment of COAD.展开更多
[Objectives]The paper was to clone and analyze bioinformatics of vscN gene from Vibrio alginolyticus.[Methods]A pair of specific primers was designed based on the vscN gene sequence of V.alginolyticus HY9901.The full ...[Objectives]The paper was to clone and analyze bioinformatics of vscN gene from Vibrio alginolyticus.[Methods]A pair of specific primers was designed based on the vscN gene sequence of V.alginolyticus HY9901.The full length of vscN gene was amplified by PCR and bioinformatics analysis was performed.[Results]The vscN gene was 1323 bp in total,encoding 440 amino acids,with the theoretical molecular weight of 47.86 kD and the theoretical pI value of 5.89.The online prediction showed that there was no signal peptide and no transmembrane region in VscN.The amino acid sequence had 10 N-myristoylation sites,8 phosphorylation sites(2 protein kinase C phosphorylation sites,6 casein kinase II phosphorylation sites),1 amidation site,11 microbody C-terminal target signal sites,1 ATP/GTP binding site motif A(P ring),and 1 ATPaseαandβsubunit specific site.Homology analysis showed that the VscN protein of V.alginolyticus had high homology with that of V.antiquarius,with a similarity of 95.14%.Phylogenetic tree analysis showed that the VscN of V.alginolyticus was clustered into the same subgroup as that of V.diabolicus and V.antiquarius.Functional domain analysis of VscN protein showed that it had Pfam and AAA domains,and involved in the regulation of bacterial virulence.The three-dimensional structure model of VscN simulated by SWISS-MODEL software was similar to the structure of flagellate-specific ATPase FliH-FliI complex.[Conclusions]The results lay a foundation for further study on the regulatory mechanism of VscN protein on bacterial virulence.展开更多
Objective To explore the ability of texture analysis of gadoxetic acid-enhanced magnetic resonance imaging(MRI) T1 mapping images, as well as T1-weighted(T1 W), T2-weighted(T2 W) and apparent diffusion coefficient(ADC...Objective To explore the ability of texture analysis of gadoxetic acid-enhanced magnetic resonance imaging(MRI) T1 mapping images, as well as T1-weighted(T1 W), T2-weighted(T2 W) and apparent diffusion coefficient(ADC) maps for distinguishing between varying degrees of hepatic fibrosis in an experimental rat model.Methods Liver fibrosis in rats was induced by carbon tetrachloride intraperitoneal injection for 4–12 weeks(n = 30). In the control group(n = 10) normal saline was applied. The MRI protocol contained T2 W, diffusion weighted imaging, pre-and post-contrast image series of T1 W and T1 mapping images. METAVIR score was used to grade liver fibrosis as normal(F0), mild fibrosis(F1–2), and advanced fibrosis(F3–4). Texture parameters including mean gray-level intensity(Mean), standard deviation(SD), Entropy, mean of positive pixels(MPP), Skewness, and Kurtosis were obtained. Nonparametric Mann-Whitney U test was used to compare the average value of each texture parameter in each sequence for assessing the difference between F0 and F≥1 as well as F0–2 and F3–4. Receiver operating characteristic(ROC) curves were obtained to assess the diagnosing accuracy of the parameters for differentiating no liver fibrosis from liver fibrosis and rats with liver fibrosis grading F0–2 from those with grading F3–4. The area under ROC curve(AUC) was calculated to evaluate the diagnostic efficiency of texture parameters.Results Finally, 20 rats completed MR T1 mapping image scan. The pathologic staging of these 20 rats was no fibrosis(F0, n = 6), mild fibrosis(F1–2, n = 5) and advanced fibrosis(F3–4, n = 9). On pre-contrast T1 mapping image, Entropy was seen to be statistically significant higher in the F≥1 group than that in the F0 group at each spatial scaling factor(SSF) setting(P = 0.015, 0.015, 0.015, 0.013, 0.015 and 0.018 respectively to SSF = 0, 2, 3, 4,5, 6), and Mean of the F≥1 rats was statistically significant higher than that of the F0 rats at SSF 4, 5, 6(P = 0.004, 0.006, and 0.013, respectively). Entropy and Mean showed a moderate diagnostic performance in most SSF settings of T1 mapping pre-contrast images for differentiation of normal liver from liver fibrosis.Conclusion Certain texture features of gadoxetic acid-enhanced MR images, especially the Entropy of noncontrast T1 mapping image, was found to be a useful biomarker for the diagnosis of liver fibrosis.展开更多
目的通过对近十年T细胞对类风湿关节炎(rheumatoid arthritis,RA)影响的文献进行多软件可视化分析,总结该领域的研究热点及前沿发展。方法在中国知网和Web of Science核心合集数据库检索2012-2022年关于T细胞对RA影响的中英文文献,运用C...目的通过对近十年T细胞对类风湿关节炎(rheumatoid arthritis,RA)影响的文献进行多软件可视化分析,总结该领域的研究热点及前沿发展。方法在中国知网和Web of Science核心合集数据库检索2012-2022年关于T细胞对RA影响的中英文文献,运用CiteSpace、VOSviewer软件对其发文量、作者、关键词进行分析。结果中文文献519篇,英文文献861篇,结果显示2020-2022年中文发文量缓慢增加,英文发文量整体趋势较为平稳。关键词分析显示,预测该领域的未来研究聚焦于T细胞在RA中的发病机制、RA的骨破坏机制、疾病活动度、氧化应激等方面。结论T细胞对RA影响的研究关注度一直较高,研究价值大。但因国内外研究重点存在差异,团队间应良性互动、相互交流,以期揭示RA的内在机制,为靶向治疗提供理论依据。展开更多
Objective To investigate the difference in tumor conventional imaging findings and texture features on T2 weighted images between glioblastoma and primary central neural system(CNS) lymphoma. Methods The pre-operative...Objective To investigate the difference in tumor conventional imaging findings and texture features on T2 weighted images between glioblastoma and primary central neural system(CNS) lymphoma. Methods The pre-operative MRI data of 81 patients with glioblastoma and 28 patients with primary CNS lymphoma admitted to the Chinese PLA General Hospital and Hainan Hospital of Chinese PLA General Hospital were retrospectively collected. All patients underwent plain MR imaging and enhanced T1 weighted imaging to visualize imaging features of lesions. Texture analysis of T2 weighted imaging(T2 WI) was performed by use of GLCM texture plugin of ImageJ software, and the texture parameters including Angular Second Moment(ASM), Contrast, Correlation, Inverse Difference Moment(IDM), and Entropy were measured. Independent sample t-test and Mann-Whitney U test were performed for the between-group comparisons, regression model was established by Binary Logistic regression analysis, and receiver operating characteristic(ROC) curve was plotted to compare the diagnostic efficacy. Results The conventional imaging features including cystic and necrosis changes(P = 0.000), ‘Rosette' changes(P = 0.000) and ‘incision sign'(P = 0.000), except ‘flame-like edema'(P = 0.635), presented significantly statistical difference between glioblastoma and primary CNS lymphoma. The texture features, ASM, Contrast, Correlation, IDM and Entropy, showed significant differences between glioblastoma and primary CNS lympoma(P = 0.006,0.000, 0.002, 0.000, and 0.015 respectively). The area under the ROC curve was 0.671, 0.752, 0.695, 0.720 and 0.646 respectively, and the area under the ROC curve was 0.917 for the combined texture variables(Contrast, cystic and necrosis, ‘Rosette' changes, and ‘incision sign') in the model of Logistic regression. Binary Logistic regression analysis demonstrated that cystic and necrosis changes, ‘Rosette' changes and ‘incision sign' and texture Contrast could be considered as the specific texture variables for the differential diagnosis of glioblastoma and primary CNS lymphoma. Conclusion The texture features of T2 WI and conventional imaging findings may be used to distinguish glioblastoma from primary CNS lymphoma.展开更多
An integration processing system of three-dimensional laser scanning information visualization in goaf was developed. It is provided with multiple functions, such as laser scanning information management for goaf, clo...An integration processing system of three-dimensional laser scanning information visualization in goaf was developed. It is provided with multiple functions, such as laser scanning information management for goaf, cloud data de-noising optimization, construction, display and operation of three-dimensional model, model editing, profile generation, calculation of goaf volume and roof area, Boolean calculation among models and interaction with the third party soft ware. Concerning this system with a concise interface, plentiful data input/output interfaces, it is featured with high integration, simple and convenient operations of applications. According to practice, in addition to being well-adapted, this system is favorably reliable and stable.展开更多
背景嵌合抗原受体(CAR)-T细胞免疫疗法已在多发性骨髓瘤(MM)中取得较好的疗效,最常见的靶点为B细胞成熟抗原(BCMA)。单靶点CAR-T细胞免疫疗法的缺点是会导致疾病抵抗和复发,可能与抗原逃逸有关。为此,改进开发了双靶点CAR-T细胞治疗复...背景嵌合抗原受体(CAR)-T细胞免疫疗法已在多发性骨髓瘤(MM)中取得较好的疗效,最常见的靶点为B细胞成熟抗原(BCMA)。单靶点CAR-T细胞免疫疗法的缺点是会导致疾病抵抗和复发,可能与抗原逃逸有关。为此,改进开发了双靶点CAR-T细胞治疗复发难治多发性骨髓瘤(RRMM),此方面尚缺乏系统的临床分析。目的对RRMM患者应用双靶点CAR-T细胞免疫疗法治疗的有效性及安全性进行Meta分析。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、维普网7个数据库中有关双靶点CAR-T细胞治疗RRMM的单组率研究,检索时限为建库至2023-02-06。由2名研究人员使用自制的数据表单来提取收集数据,并采用非随机对照试验方法学评价指标进行文献质量评价。采用R Studio软件进行数据分析。结果共纳入9篇文献,包括200例既往接受过多线治疗的RRMM患者。双靶点CAR-T细胞疗法根据不同靶点可分为4类:BCMA+CD19、BCMA+CD38,BCMA+跨膜剂与钙调节亲环素配体的相互作用者(TACI)、BCMA+人信号淋巴细胞激活分子家族成员7(CS1),其中BCMA+CD19靶点的研究较多。根据输注形式不同CAR-T细胞疗法可分为4类:双特异性CAR-T细胞、联合或序贯输注两种不同CAR-T细胞、双顺反子结构、共转导。Meta分析显示,双靶点CAR-T细胞治疗RRMM的总缓解率(ORR)为90.0%(95%CI=0.849~0.943),完全缓解率(CRR)为54.6%(95%CI=0.416~0.673),微小残留病(MRD)阴性率为75.6%(95%CI=0.489~0.952),髓外病变(EMD)总缓解率为55.1%(95%CI=0.234~0.851),最后一次随访时的复发率为29.7%(95%CI=0.141~0.454),最后一次随访时的生存率为75.6%(95%CI=0.554~0.915),3~4级细胞释放因子综合征(CRS)发生率为16.4%(95%CI=0.094~0.245),神经毒性(ICANS)发生率为4.0%(95%CI=0~0.120)。敏感性分析提示结果稳定。Egger's检验结果显示,ORR(P=0.03)及EMD总缓解率(P=0.02)提示存在一定的偏倚风险;CRR(P=0.53)、MRD阴性率(P=0.79)、最后一次随访时的复发率(P=0.71)、生存率(P=0.98)、3~4级CRS发生率(P=0.90)、ICANS发生率(P=0.30)提示不存在发表偏倚。结论双靶点CAR-T细胞免疫治疗RRMM显示出良好的疗效和安全性,未来需要多中心、大样本、更长随访期的研究来进一步评估其疗效和安全性。展开更多
基金Guizhou Provincial Department of Science and Technology Natural Science Foundation(No Foundation-ZK[2022])the Guizhou Provincial Health Commission Science and Technology Fund(No.GZWKJ2023-135)the Science Foundation of 925th Hospital(No.2023[3],No.2022[3/4]).
文摘Background:The cyclin-dependent kinase inhibitor 2a(CDKN2A)gene,identified as the multiple tumor suppressor gene,functions as a regulatory gene implicated in cancer pathogenesis.Its significance lies in its pivotal involvement in the genesis of various tumors;notwithstanding,the precise connection between CDKN2A and c olon adenocarcinoma(COAD)remains undisclosed.Methods:The objective of this research was to assess the predictive importance of CDKN2A in COAD by analyzing data from The Cancer Genome Atlas database.Logistic regression,signed rank test,Wilcoxon test,and Kruskal-Wallis test were used to examine CDKN2A expression levels and clinicopathological features.Univariate and multivariate Cox r egression analyses and Kaplan-Meier analysis found prognostic variables.Additionally,gene set enrichment analysis identified key CDKN2A expression pathways.The study additionally examined CDKN2A expression with tumor immune infiltration using The Cancer Genome Atlas data and single sample gene set enrichment analysis.Results:The results of this investigation indicated a substantial connection between higher CDKN2A expression and negative outcomes in terms of overall survival and disease-related survival among COAD patients.Gene set enrichment analysis indicated a tight link between CDKN2A and both the cell cycle and hedgehog signaling pathways.Subsequent evaluation employing single sample gene set enrichment analysis demonstrated a positive link between CDKN2A expression with infiltration by iDCs,whereas a negative correlation was detected with infiltration by helper T cells.Conclusion:In conclusion,the present study gives strong data supporting the predictive value of CDKN2A and its possible usefulness as a biomarker for COAD.Additionally,our results show a reasonable link between CDKN2A expression and immune influx in COAD,putting light on the role of CDKN2A in the control of the tumor microenvironment.Nevertheless,additional studies are needed to confirm the underlying mechanisms of these relationships and to discover the therapeutic possibilities of targeting CDKN2A in the treatment of COAD.
基金Supported by Outstanding Graduate Entering Laboratory Project of College of FisheriesGuangdong Ocean University+3 种基金National Natural Science Foundation of China (32073015)Natural Science Foundation of Guangdong Province(2021A1515011078)Undergraduate Innovation and Entrepreneurship Training Program of Guangdong Ocean University (CXXL2022005)Undergraduate Innovation Team of Guangdong Ocean University (CCTD201802)
文摘[Objectives]The paper was to clone and analyze bioinformatics of vscN gene from Vibrio alginolyticus.[Methods]A pair of specific primers was designed based on the vscN gene sequence of V.alginolyticus HY9901.The full length of vscN gene was amplified by PCR and bioinformatics analysis was performed.[Results]The vscN gene was 1323 bp in total,encoding 440 amino acids,with the theoretical molecular weight of 47.86 kD and the theoretical pI value of 5.89.The online prediction showed that there was no signal peptide and no transmembrane region in VscN.The amino acid sequence had 10 N-myristoylation sites,8 phosphorylation sites(2 protein kinase C phosphorylation sites,6 casein kinase II phosphorylation sites),1 amidation site,11 microbody C-terminal target signal sites,1 ATP/GTP binding site motif A(P ring),and 1 ATPaseαandβsubunit specific site.Homology analysis showed that the VscN protein of V.alginolyticus had high homology with that of V.antiquarius,with a similarity of 95.14%.Phylogenetic tree analysis showed that the VscN of V.alginolyticus was clustered into the same subgroup as that of V.diabolicus and V.antiquarius.Functional domain analysis of VscN protein showed that it had Pfam and AAA domains,and involved in the regulation of bacterial virulence.The three-dimensional structure model of VscN simulated by SWISS-MODEL software was similar to the structure of flagellate-specific ATPase FliH-FliI complex.[Conclusions]The results lay a foundation for further study on the regulatory mechanism of VscN protein on bacterial virulence.
基金Supported by the National Science Foundation of China(Grant No.81501446)the National Public Welfare Basic Scientific Research Program of Chinese Academy of Medical Sciences(2018PT32003 and 2017PT32004)
文摘Objective To explore the ability of texture analysis of gadoxetic acid-enhanced magnetic resonance imaging(MRI) T1 mapping images, as well as T1-weighted(T1 W), T2-weighted(T2 W) and apparent diffusion coefficient(ADC) maps for distinguishing between varying degrees of hepatic fibrosis in an experimental rat model.Methods Liver fibrosis in rats was induced by carbon tetrachloride intraperitoneal injection for 4–12 weeks(n = 30). In the control group(n = 10) normal saline was applied. The MRI protocol contained T2 W, diffusion weighted imaging, pre-and post-contrast image series of T1 W and T1 mapping images. METAVIR score was used to grade liver fibrosis as normal(F0), mild fibrosis(F1–2), and advanced fibrosis(F3–4). Texture parameters including mean gray-level intensity(Mean), standard deviation(SD), Entropy, mean of positive pixels(MPP), Skewness, and Kurtosis were obtained. Nonparametric Mann-Whitney U test was used to compare the average value of each texture parameter in each sequence for assessing the difference between F0 and F≥1 as well as F0–2 and F3–4. Receiver operating characteristic(ROC) curves were obtained to assess the diagnosing accuracy of the parameters for differentiating no liver fibrosis from liver fibrosis and rats with liver fibrosis grading F0–2 from those with grading F3–4. The area under ROC curve(AUC) was calculated to evaluate the diagnostic efficiency of texture parameters.Results Finally, 20 rats completed MR T1 mapping image scan. The pathologic staging of these 20 rats was no fibrosis(F0, n = 6), mild fibrosis(F1–2, n = 5) and advanced fibrosis(F3–4, n = 9). On pre-contrast T1 mapping image, Entropy was seen to be statistically significant higher in the F≥1 group than that in the F0 group at each spatial scaling factor(SSF) setting(P = 0.015, 0.015, 0.015, 0.013, 0.015 and 0.018 respectively to SSF = 0, 2, 3, 4,5, 6), and Mean of the F≥1 rats was statistically significant higher than that of the F0 rats at SSF 4, 5, 6(P = 0.004, 0.006, and 0.013, respectively). Entropy and Mean showed a moderate diagnostic performance in most SSF settings of T1 mapping pre-contrast images for differentiation of normal liver from liver fibrosis.Conclusion Certain texture features of gadoxetic acid-enhanced MR images, especially the Entropy of noncontrast T1 mapping image, was found to be a useful biomarker for the diagnosis of liver fibrosis.
文摘目的通过对近十年T细胞对类风湿关节炎(rheumatoid arthritis,RA)影响的文献进行多软件可视化分析,总结该领域的研究热点及前沿发展。方法在中国知网和Web of Science核心合集数据库检索2012-2022年关于T细胞对RA影响的中英文文献,运用CiteSpace、VOSviewer软件对其发文量、作者、关键词进行分析。结果中文文献519篇,英文文献861篇,结果显示2020-2022年中文发文量缓慢增加,英文发文量整体趋势较为平稳。关键词分析显示,预测该领域的未来研究聚焦于T细胞在RA中的发病机制、RA的骨破坏机制、疾病活动度、氧化应激等方面。结论T细胞对RA影响的研究关注度一直较高,研究价值大。但因国内外研究重点存在差异,团队间应良性互动、相互交流,以期揭示RA的内在机制,为靶向治疗提供理论依据。
文摘Objective To investigate the difference in tumor conventional imaging findings and texture features on T2 weighted images between glioblastoma and primary central neural system(CNS) lymphoma. Methods The pre-operative MRI data of 81 patients with glioblastoma and 28 patients with primary CNS lymphoma admitted to the Chinese PLA General Hospital and Hainan Hospital of Chinese PLA General Hospital were retrospectively collected. All patients underwent plain MR imaging and enhanced T1 weighted imaging to visualize imaging features of lesions. Texture analysis of T2 weighted imaging(T2 WI) was performed by use of GLCM texture plugin of ImageJ software, and the texture parameters including Angular Second Moment(ASM), Contrast, Correlation, Inverse Difference Moment(IDM), and Entropy were measured. Independent sample t-test and Mann-Whitney U test were performed for the between-group comparisons, regression model was established by Binary Logistic regression analysis, and receiver operating characteristic(ROC) curve was plotted to compare the diagnostic efficacy. Results The conventional imaging features including cystic and necrosis changes(P = 0.000), ‘Rosette' changes(P = 0.000) and ‘incision sign'(P = 0.000), except ‘flame-like edema'(P = 0.635), presented significantly statistical difference between glioblastoma and primary CNS lymphoma. The texture features, ASM, Contrast, Correlation, IDM and Entropy, showed significant differences between glioblastoma and primary CNS lympoma(P = 0.006,0.000, 0.002, 0.000, and 0.015 respectively). The area under the ROC curve was 0.671, 0.752, 0.695, 0.720 and 0.646 respectively, and the area under the ROC curve was 0.917 for the combined texture variables(Contrast, cystic and necrosis, ‘Rosette' changes, and ‘incision sign') in the model of Logistic regression. Binary Logistic regression analysis demonstrated that cystic and necrosis changes, ‘Rosette' changes and ‘incision sign' and texture Contrast could be considered as the specific texture variables for the differential diagnosis of glioblastoma and primary CNS lymphoma. Conclusion The texture features of T2 WI and conventional imaging findings may be used to distinguish glioblastoma from primary CNS lymphoma.
基金Project(51274250)supported by the National Natural Science Foundation of ChinaProject(2012BAK09B02-05)supported by the National Key Technology R&D Program during the 12th Five-year Plan of China
文摘An integration processing system of three-dimensional laser scanning information visualization in goaf was developed. It is provided with multiple functions, such as laser scanning information management for goaf, cloud data de-noising optimization, construction, display and operation of three-dimensional model, model editing, profile generation, calculation of goaf volume and roof area, Boolean calculation among models and interaction with the third party soft ware. Concerning this system with a concise interface, plentiful data input/output interfaces, it is featured with high integration, simple and convenient operations of applications. According to practice, in addition to being well-adapted, this system is favorably reliable and stable.
文摘背景嵌合抗原受体(CAR)-T细胞免疫疗法已在多发性骨髓瘤(MM)中取得较好的疗效,最常见的靶点为B细胞成熟抗原(BCMA)。单靶点CAR-T细胞免疫疗法的缺点是会导致疾病抵抗和复发,可能与抗原逃逸有关。为此,改进开发了双靶点CAR-T细胞治疗复发难治多发性骨髓瘤(RRMM),此方面尚缺乏系统的临床分析。目的对RRMM患者应用双靶点CAR-T细胞免疫疗法治疗的有效性及安全性进行Meta分析。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、维普网7个数据库中有关双靶点CAR-T细胞治疗RRMM的单组率研究,检索时限为建库至2023-02-06。由2名研究人员使用自制的数据表单来提取收集数据,并采用非随机对照试验方法学评价指标进行文献质量评价。采用R Studio软件进行数据分析。结果共纳入9篇文献,包括200例既往接受过多线治疗的RRMM患者。双靶点CAR-T细胞疗法根据不同靶点可分为4类:BCMA+CD19、BCMA+CD38,BCMA+跨膜剂与钙调节亲环素配体的相互作用者(TACI)、BCMA+人信号淋巴细胞激活分子家族成员7(CS1),其中BCMA+CD19靶点的研究较多。根据输注形式不同CAR-T细胞疗法可分为4类:双特异性CAR-T细胞、联合或序贯输注两种不同CAR-T细胞、双顺反子结构、共转导。Meta分析显示,双靶点CAR-T细胞治疗RRMM的总缓解率(ORR)为90.0%(95%CI=0.849~0.943),完全缓解率(CRR)为54.6%(95%CI=0.416~0.673),微小残留病(MRD)阴性率为75.6%(95%CI=0.489~0.952),髓外病变(EMD)总缓解率为55.1%(95%CI=0.234~0.851),最后一次随访时的复发率为29.7%(95%CI=0.141~0.454),最后一次随访时的生存率为75.6%(95%CI=0.554~0.915),3~4级细胞释放因子综合征(CRS)发生率为16.4%(95%CI=0.094~0.245),神经毒性(ICANS)发生率为4.0%(95%CI=0~0.120)。敏感性分析提示结果稳定。Egger's检验结果显示,ORR(P=0.03)及EMD总缓解率(P=0.02)提示存在一定的偏倚风险;CRR(P=0.53)、MRD阴性率(P=0.79)、最后一次随访时的复发率(P=0.71)、生存率(P=0.98)、3~4级CRS发生率(P=0.90)、ICANS发生率(P=0.30)提示不存在发表偏倚。结论双靶点CAR-T细胞免疫治疗RRMM显示出良好的疗效和安全性,未来需要多中心、大样本、更长随访期的研究来进一步评估其疗效和安全性。