Nayama M, Collinet P, Salzet M, Vinatier D
Service de gynécologie obstétrique, maternité Issaka-Gazoby, BP 10975, Niamey, Niger.
CHU de Lille, 59000 Lille, France; Département universitaire de gynécologie obstétrique, université Nord-de-France, 59045 Lille cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2016 Nov;45(9):1020-1036. doi: 10.1016/j.jgyn.2016.05.005. Epub 2016 Jun 16.
Ovarian cancer is recognized by the immunological system of its host. Initially, it is effective to destroy and eliminate the cancer. But gradually, resistant tumor cells more aggressive and those able to protect themselves by inducing immune tolerance will be selected. Immunotherapy to be effective should consider both components of immune response with an action on cytotoxic immune effectors and action on tolerance mechanisms. The manipulations of the immune system should be cautious, because the immune effects are not isolated. A theoretically efficient handling may simultaneously cause an adverse effect which was not envisaged and could neutralize the benefits of treatment. Knowledge of tolerance mechanisms set up by the tumor is for the clinician a prerequisite before they prescribe these treatments. For each cancer, the knowledge of its immunological status is a prerequisite to propose adapted immunological therapies.
卵巢癌会被宿主的免疫系统识别。起初,免疫系统能够有效摧毁并清除癌症。但逐渐地,更具侵袭性且能够通过诱导免疫耐受来保护自身的耐药肿瘤细胞会被筛选出来。要使免疫疗法有效,就应同时考虑免疫反应的两个组成部分,即对细胞毒性免疫效应器的作用以及对耐受机制的作用。对免疫系统的操控应谨慎,因为免疫效应并非孤立存在。一种理论上有效的操作可能同时引发未曾预料到的不良反应,从而抵消治疗带来的益处。在临床医生开具这些治疗方案之前,了解肿瘤建立的耐受机制是一个前提条件。对于每种癌症而言,了解其免疫状态是提出合适免疫疗法的前提条件。