Evans C, Dalgleish A G, Kumar D
Institution Colorectal Surgery Unit & Division of Oncology, St George's Hospital, Blackshaw Road, London, UK.
Aliment Pharmacol Ther. 2006 Oct 15;24(8):1163-77. doi: 10.1111/j.1365-2036.2006.03075.x.
Advances in immunology and molecular biology have shown that colorectal cancer is potentially immunogenic and that host immune responses influence survival. However, immune surveillance and activation is frequently ineffective in preventing and/or controlling tumour growth.
To discuss potential ways in which colorectal cancer induces immune suppression, its effect upon prognosis and avenues for therapeutic development.
A literature review was undertaken for evidence of colorectal cancer-induced immune suppression using PubMed and Medline searches. Further studies were identified from the reference lists of identified papers.
Immune suppression occurs at a molecular and cellular level and can result in a shift from cellular to humoral immunity. Several mechanisms for immune suppression have been described affecting innate and adaptive immunity with suppression linked to poorer clinical outcome.
Colorectal cancer causes direct inhibition of the host's immune response with a detrimental effect upon prognosis. Immunotherapy offers a therapeutic strategy to counteract these effects with promising results seen particularly in precancerous conditions and early tumours. This review strongly suggests that immunotherapy should be incorporated into adjuvant therapeutic trials for stage 2 tumours and be considered as adjuvant treatment in conjunction with standard chemotherapy regimes for advanced disease.
免疫学和分子生物学的进展表明，结直肠癌具有潜在的免疫原性，宿主免疫反应会影响生存。然而，免疫监视和激活在预防和/或控制肿瘤生长方面往往无效。
探讨结直肠癌诱导免疫抑制的潜在方式、其对预后的影响以及治疗发展的途径。
通过PubMed和Medline检索，对结直肠癌诱导免疫抑制的证据进行文献综述。从已识别论文的参考文献列表中确定进一步的研究。
免疫抑制发生在分子和细胞水平，可导致从细胞免疫向体液免疫的转变。已经描述了几种免疫抑制机制，这些机制影响先天性和适应性免疫，且免疫抑制与较差的临床结果相关。
结直肠癌直接抑制宿主的免疫反应，对预后产生不利影响。免疫疗法提供了一种治疗策略来对抗这些影响，尤其在癌前病变和早期肿瘤中取得了有希望的结果。本综述强烈建议，免疫疗法应纳入2期肿瘤的辅助治疗试验，并应考虑与晚期疾病的标准化疗方案联合作为辅助治疗。
