Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Neurosurgery. 2012 Aug;71(2):201-22; discussion 222-3. doi: 10.1227/NEU.0b013e31824f840d.
Significant work from many laboratories over the last decade in the study of cancer immunology has resulted in the development of the cancer immunoediting hypothesis. This contemporary framework of the naturally arising immune system-tumor interaction is thought to comprise 3 phases: elimination, wherein immunity subserves an extrinsic tumor suppressor function and destroys nascent tumor cells; equilibrium, wherein tumor cells are constrained in a period of latency under immune control; and escape, wherein tumor cells outpace immunity and progress clinically. In this review, we address in detail the relevance of the cancer immunoediting concept to neurosurgeons and neuro-oncologists treating and studying malignant glioma by exploring the de novo immune response to these tumors, how these tumors may persist in vivo, the mechanisms by which these cells may escape/attenuate immunity, and ultimately how this concept may influence our immunotherapeutic approaches.
过去十年间，许多实验室在癌症免疫学研究方面取得了重大进展，提出了癌症免疫编辑假说。这一新兴的天然免疫系统与肿瘤相互作用框架被认为包含三个阶段：消除，其中免疫起到外在的肿瘤抑制作用并摧毁新生的肿瘤细胞；平衡，其中肿瘤细胞在免疫控制下处于潜伏期；逃逸，其中肿瘤细胞超过免疫并在临床上进展。在这篇综述中，我们通过探讨对这些肿瘤的新出现的免疫反应、这些肿瘤如何在体内持续存在、这些细胞可能逃避/减弱免疫的机制，以及最终这一概念如何影响我们的免疫治疗方法，详细探讨了癌症免疫编辑概念对治疗和研究恶性胶质瘤的神经外科医生和神经肿瘤学家的相关性。
