从卡介苗成功治疗膀胱癌论肿瘤的免疫治疗

卡介苗(BCG)膀胱内灌注是治疗浅表性膀胱癌一种最有效的方法。通过对治疗后的监测发现,卡介苗灌注后可引发肿瘤部位显著的固有免疫和适应性免疫细胞反应,体内大多数的抗肿瘤免疫效应细胞参与这一反应过程。这一结果表明,有效的肿瘤免疫治疗必须由固有免疫和适应性免疫细胞协同作用才能完成。     

整体观视角下的肿瘤发病机制

肿瘤不只是局部病变,更是整体调控失常的表现。肿瘤微环境下的营养代谢障碍可以导致免疫细胞抗肿瘤效应低下,甚至可能使免疫细胞沦为肿瘤的帮凶。因此,必须仔细评估肿瘤局部乃至全身的代谢和免疫状态,给予适当的调整,使得免疫功能正常发挥,这才是治疗肿瘤的关键。     

肿瘤免疫中的细胞凋亡

在肿瘤免疫编辑的三个阶段：清除、平衡和逃逸,细胞凋亡发挥重要作用。清除阶段,免疫细胞通过诱导肿瘤细胞凋亡发挥免疫清除作用;平衡阶段,在免疫选择作用下,肿瘤细胞凋亡促进肿瘤恶性演进;逃逸阶段,肿瘤细胞凋亡耐受性增强,进而反向促使免疫细胞凋亡,削弱肌体免疫力,产生免疫耐受。     

肿瘤生物治疗的研究趋势及思考

肿瘤生物治疗是一种既古老又年轻的疗法 ,上溯千余年 ,在中医药中有“扶正祛邪、软坚散结、以毒攻毒、活血化瘀”等利用中药来治疗癌症的治则。 19世纪末 ,西方提出Ｃｏｌｅｙ毒素治疗癌症 ,现代肿瘤免疫治疗概念的建立始于 1953年 ,动物肿瘤特异性移植抗原的发现———肿瘤免疫学的诞生 ,此后至 1983年多种非特异性生物制剂 (卡介苗、短小棒状杆菌、免疫核糖核酸、转移因子等 )的大量临床应用和动物实验为人类的肿瘤免疫治疗奠定了科学基础。 2 0世纪中叶 ,伴随着现代分子生物学和生物工程技术的发展重组的细胞因子的出现 ,第一例肿瘤病人…     

临床肿瘤治疗决策的思考

肿瘤是一种全身性疾病,虽表现为局部的肿块,但其实质是全身免疫功能受损导致某些组织失去控制的异常生长,机体内部由于肿瘤的生长而发生了许多改变.肿瘤治疗的目的在于延长患者生存时间,即与疾病共生存.肿瘤并发症的治疗和术后肿瘤复发或再生的预防在改善生存方面发挥着重要作用.严格的技术准入和规范化治疗是提高治疗效果的保证.     

肿瘤免疫编辑与免疫治疗

Schreiber等人于2002年提出肿瘤免疫编辑学说.肿瘤免疫编辑分为3个阶段:清除阶段、均衡阶段和逃逸阶段.肿瘤免疫编辑学说较全面的阐释了肿瘤与宿主免疫系统之间的复杂的相互作用.肿瘤免疫编辑学说对肿瘤免疫治疗具有一定的指导意义.依据肿瘤免疫治疗实践,提出了肿瘤免疫编辑和肿瘤免疫治疗的一些观点.     

浅析肿瘤疫苗

肿瘤疫苗作为肿瘤特异性主动免疫治疗的方式,目的是激发启动,调节增强机体固有的免疫功能和抗癌能力以维护机体生理平衡。具有使机体由被动抗癌向主动抗癌转变的特点。     

肿瘤免疫治疗需要综合性

自从人们发现肿瘤与免疫有密切关系以来,对肿瘤免疫治疗寄予了厚望,然而,由于免疫机制、免疫途径的网络性和复杂性,免疫治疗未从根本上改变肿瘤治疗的现状,而仅仅是传统治疗手段的有益补充.     

肿瘤免疫编辑理论与树突状细胞个体化治疗肿瘤策略的思考

利用树突状细胞瘤苗提高机体免疫系统对肿瘤的特异杀伤能力,已成为肿瘤免疫治疗中的研究热点.根据肿瘤免疫编辑理论,肿瘤免疫可分为清除、平衡和逃逸3个阶段.应用该理论阐述应用树突状细胞个体化治疗肿瘤的策略具有重要意义.     

利用同种异体移植排斥机制治疗恶性肿瘤：从辩证的角度提出的一种设想

荷瘤宿主对肿瘤的免疫反应低下，不能诱导有效的抗肿瘤免疫；器官移植时，由于供受体之间组织相容性复合物的不同，诱发移植排斥反应，往往导致移植器官功能丧失和器官死亡。利用辩证的逆向思维方法，将对器官移植不利的移植排斥反应引入恶性肿瘤的免疫治疗，可能是一条有希望的治疗途径。此设想在方法上有其可行性，而且类比大量的肿瘤免疫治疗和基因治疗的最新研究成果，此设想有可能取得预期的结果。     

居家管理在乳腺癌所致癌因性疲乏中的应用

探讨居家管理在乳腺癌所致癌因性疲乏的应用.选取2010年3月至2011年10月行乳腺癌术后化疗的60例患者并进行分组,比较两组出院时与出院1个月后患者对癌因性疲乏缓解的相关健康知识的掌握情况及Piper疲乏自测量表效果评分.结论为居家管理对乳腺癌所致癌因性疲乏的缓解有积极作用,提高患者的遵医行为.     

Neuropsychological Sequelae of Non-Central Nervous System Cancer and Cancer Therapy

Cancer patients report numerous adverse symptoms associated with their disease and treatment including cognitive dysfunction, fatigue, and affective distress. Cognitive dysfunction is ubiquitous in patients with primary central nervous system (CNS) cancer and recent evidence has documented similar deficits in patients with non-CNS cancer as well. Both the cancer itself and treatments including chemotherapy, biological response modifiers, and hormonal therapies have been demonstrated to adversely impact cognitive and neurobehavioral function. Neuroimaging and neurophysiological investigations have likewise revealed alterations in brain function that are helping to account for the nature of these cognitive disorders. Similarly, preclinical animal research is assisting to identify the pathophysiological mechanisms that underlie treatment-related neurotoxicities. The coalescence of multidisciplinary clinical and research efforts hold promise for the development of interventions that may offer neuroprotection in addition to currently available symptomatic therapies and cognitive rehabilitation techniques.     

Cancer Worry,Perceived Risk and Cancer Screening in First-Degree Relatives of Patients with Familial Gastric Cancer

Currently, there is a lack of evidence evaluating the psychological impact of cancer-related risk perception and worry in individuals at high risk for gastric cancer. We examined the relationships between perceived risk, cancer worry and screening behaviors among first-degree relatives (FDRs) of patients with familial gastric cancer. FDRs of patients diagnosed with familial gastric cancer with a non-informative genetic analysis were identified and contacted. Participants completed a telephone interview that assessed socio-demographic information, cancer risk perception, cancer worry, impact of worry on daily functioning, and screening behaviors. Twenty-five FDRs completed the telephone interview. Participants reported high levels of comparative and absolute cancer risk perception, with an average perceived lifetime risk of 54 %. On the other hand, cancer-related worry scores were low, with a significant minority (12 %) experiencing high levels of worry. Study participants exhibited high levels of confidence (median = 70 %) in the effectiveness of screening at detecting a curable cancer. Participants that had undergone screening in the past showed significantly lower levels of cancer-related worry compared to those that had never undergone screening. In conclusion, individuals at high-risk for gastric cancer perceived a very high personal risk of cancer, but reported low levels of cancer worry. This paradoxical result may be attributed to participants’ high levels of confidence in the effectiveness of screening. These findings highlight the importance for clinicians to discuss realistic risk appraisals and expectations towards screening with unaffected members of families at risk for gastric cancer, in an effort to help mitigate anxiety and help with coping.     

The Familial Cancer Program of the Vermont Cancer Center: Development of a Cancer Genetics Program in a Rural Area

In response to many scientific discoveries linking cancer in certain families to inherited factors, the Vermont Cancer Center established the Familial Cancer Program (FCP) in December 1993. This multifaceted program combines the expertise of clinicians and researchers in many disciplines, including genetics, oncology, psychology, and molecular biology. The program's goals are identification of families in its region with excess cancer, provision of clinical services to such families, and use of research protocols when available and appropriate. This article describes the experience of setting up a familial cancer program in a rural area and discusses both successes and challenges in such an endeavor.     

Cognitive Effects of Cancer Chemotherapy in Adult Cancer Survivors: Cognitive-Behavioral Management

Problems of memory and attention following cancer chemotherapies have gained increasing research attention in the last 2 decades. The President’s Cancer Panel and the National Coalition for Cancer Survivorship formally recognized the problem as a quality of life matter in the 1990s (Ferrell and Hassey in Oncology 11:565–576, 1997; President’s Cancer Panel in Cancer Care Issues in the United States: Quality of Care, Quality of Life, National Cancer Program, National Cancer Institute, 1999). In combination with an aging population, advances in biomedical technologies for detection and treatment of life-threatening cancers, more people than ever are living with cancer or have been diagnosed and treated for cancer. An estimated 10-million individuals living in the U.S. are considered to be in “cancer survivorship” (Institute of Medicine 2005). Given the potential large scope of the problem of cognitive effects of cancer chemotherapies, there is a strong demand to address this survivorship matter and develop methods to optimally manage it. This article will summarize the current knowledge of chemotherapy-related cognitive change and describe a developing cognitive-behavioral treatment that is being studied to aid survivors with chemotherapy-related cognitive problems.     

Cancer and suicide

Mortality rates from suicide and cancer in 1990 in 37 European nations were positively associated.     

浅谈饮食与癌

不同国家不同地区在癌症发病率的差异很可能与不同国家、不同地区人民的饮食习惯有着密切的关系 ,某些食物中含有潜在致癌物 ,而某些食物的成份又有助于预防癌的发生。目前媒介也把主要注意力放在食物与癌的关系上。研究表明 ,因癌症死亡的人中有 35%是饮食方面的原因 ,但食物致癌的论点又常常引起争论。ｌ　吸烟与癌1.ｌ　吸烟造成的癌死亡率占全部癌症死亡率的30 % :吸烟是人类患癌的主要原因 ,吸烟与肺癌发病有直接关系 ,80 %的肺癌是吸烟所致[1] 。由于肺癌是最常见的恶性肿瘤 ,占全部癌病死亡率的 2 0 %以上[1] 。吸烟还与其它几种癌的…     

Self-Reported Questionnaire Detects Family History of Cancer in a Pancreatic Cancer Screening Program

Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer death; approximately 5–10% of PDAC is hereditary. Self-administered health history questionnaires (HHQs) may provide a low-cost method to detail family history (FH) of malignancy. Pancreas Center patients were asked to enroll in a registry; 149 with PDAC completed a HHQ which included FH data. Patients with FH of PDAC, or concern for inherited PDAC syndrome, were separately evaluated in a Prevention Program and additionally met with a genetic counselor (GC) to assess PDAC risk (n?=?61). FH obtained through GC and HHQ were compared using Wilcoxon signed-rank sum and generalized linear mixed models with Poisson distribution. Agreement between GC and HHQ risk-assessment was assessed using kappa (κ) statistic. In the Prevention Program, HHQ was as precise in detecting FH of cancer as the GC (all p?>?0.05). GC and HHQ demonstrated substantial agreement in risk-stratification of the Prevention Program cohort (κ?=?0.73, 95% CI 0.59–0.87.) The sensitivity of the HHQ to detect a patient at elevated risk (i.e., moderate- or high-risk) of PDAC, compared to GC, was 82.9% (95% CI 67.3–92.3%) with a specificity of 95% (95% CI 73.1–99.7%). However, seven patients who were classified as average-risk by the HHQ were found to be at an elevated-risk of PDAC by the GC. In the PDAC cohort, 30/149 (20.1%) reported at least one first-degree relative (FDR) with PDAC. The limited sensitivity of the HHQ to detect patients at elevated risk of PDAC in the Prevention Program cohort suggests that a GC adds value in risk-assessment in this population. The HHQ may offer an opportunity to identify high-risk patients in a PDAC population.