Bertolaccini L, Olivero G
Cattedra di Chirurgia d Urgenza e di Pronto Soccorso, Università degli Studi, Turin, Italy.
Minerva Chir. 2001 Apr;56(2):183-91.
The idea that there might be an immune response to cancer has been around for many years. Immunotherapy has a long history, but is only rarely considered as the treatment of choice. Immunotherapy has encountered a number of intrinsic difficulties in cancer, such as the antigenic resemblance between the tumour and normal cells, the rapid kinetic proliferation of tumour cells and their reduced immunogenicity. There are various types of immunotherapy. Aspecific immunotherapy augments the body s immune response without targeting specific tumoral antigens. In adoptive immunotherapy, cells are administered with antitumoral reactivity to mediate neoplasm regression. Specific active immunotherapy is based on the principle that neoplasm cells contain immunogenic sites against which an antitumoral immune response can be induced in an attempt to stimulate the immune system to target specific tumoral antigens. Vaccines against cancer cells are based on a more precise identification of the tumoral antigen components. Passive immunotherapy was limited by the difficulty of obtaining high titering and specificity in early attempts using polyclonal antisera; monoclonal antibodies are currently used alone or in association with radioactive substances and cytotoxic agents. Enormous progress has been made this century in the use of immunotherapy for cancer treatment. It seems likely that the next century will see its increased afficacy, making it one of the possible therapeutic options.
对癌症可能存在免疫反应的观点已经存在多年。免疫疗法历史悠久，但很少被视为首选治疗方法。免疫疗法在癌症治疗中遇到了一些内在困难，例如肿瘤与正常细胞之间的抗原相似性、肿瘤细胞的快速增殖动力学及其免疫原性降低。免疫疗法有多种类型。非特异性免疫疗法可增强机体的免疫反应，而不针对特定的肿瘤抗原。在过继性免疫疗法中，给予具有抗肿瘤反应性的细胞以介导肿瘤消退。特异性主动免疫疗法基于这样的原理，即肿瘤细胞含有免疫原性位点，针对这些位点可诱导抗肿瘤免疫反应，试图刺激免疫系统靶向特定的肿瘤抗原。抗癌细胞疫苗基于对肿瘤抗原成分更精确的识别。被动免疫疗法在早期使用多克隆抗血清的尝试中受到难以获得高滴度和特异性的限制；目前单克隆抗体单独使用或与放射性物质和细胞毒性药物联合使用。本世纪在免疫疗法用于癌症治疗方面取得了巨大进展。下个世纪其疗效似乎有可能提高，使其成为可能的治疗选择之一。
