Department of Clinical Research, Breisacherstr. 117, D-79106 Freiburg, Germany.
Anticancer Res. 2009 Nov;29(11):4795-805.
The latest research results suggest that tumour-infiltrating leukocytes and the intra-tumoural cytokine environment play a central role in both the genesis and development of cancer. Over a hundred years ago, Virchow pointed out that numerous immune cells occur in the vicinity of practically all malignant tumours and that the structure of tumour tissue closely resembles the inflamed region of a non-healing wound. With the aid of the latest molecular and cell-biological methods, we are not only able today to closely characterise tumour cells and their immediate vicinity but also the other cell types present in tumour tissue, such as infiltrating immune cells, endothelial cells, connective tissue cells and others, both in terms of phenotype and function. In addition, there is growing understanding of the significance of the composition and functioning of endogenous messenger substances such as cytokines, chemokines and prostaglandins in healthy and malignantly altered tissues. From the immunological point of view, the main characteristics are dysregulated inflammatory conditions caused by the tumour cells themselves or by external factors, depending on the type of tumour event. It is evident that prolonged dysregulated inflammatory conditions favour not only carcinogenesis but also the local infiltration and metastasis of malignantly modified cells and counteract the development of efficient antitumor immunity. On the other hand, there are indications that through the polarisation of immunological reactions, the ability of immunological regulator and effector cells to induce efficient antitumor immunity can be modulated. Within the framework of this summary, the essential immunological aspects of tumour formation and tumour development known at present are presented and possible new therapeutic strategies are discussed.
最新研究结果表明，肿瘤浸润白细胞和肿瘤内细胞因子环境在癌症的发生和发展中起着核心作用。一百多年前，Virchow 指出，实际上几乎所有恶性肿瘤的附近都存在大量免疫细胞，肿瘤组织的结构非常类似于未愈合伤口的炎症区域。借助最新的分子和细胞生物学方法，我们不仅能够密切描述肿瘤细胞及其周围环境，还能够描述肿瘤组织中存在的其他细胞类型，如浸润免疫细胞、内皮细胞、结缔组织细胞等，无论是在表型还是功能方面。此外，人们越来越了解内源性信使物质（如细胞因子、趋化因子和前列腺素）在健康和恶性改变组织中的组成和功能的重要性。从免疫学的角度来看，主要特征是由肿瘤细胞本身或外部因素引起的失调的炎症状态，具体取决于肿瘤事件的类型。显然，长期失调的炎症状态不仅有利于癌变，还有利于恶性改变细胞的局部浸润和转移，并阻碍有效的抗肿瘤免疫的发展。另一方面，有迹象表明，通过免疫反应的极化，可以调节免疫调节剂和效应细胞诱导有效抗肿瘤免疫的能力。在本综述的框架内，目前介绍了肿瘤形成和肿瘤发展的基本免疫学方面，并讨论了可能的新治疗策略。
