Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Division of Cancer Sciences, University of Manchester & Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
J Hepatol. 2023 Sep;79(3):867-875. doi: 10.1016/j.jhep.2023.05.010. Epub 2023 May 16.
Recent literature has significantly advanced our knowledge and understanding of the tumour immune microenvironment of cholangiocarcinoma. Detailed characterisation of the immune landscape has defined new patient subtypes. While not utilised in clinical practice yet, these novel classifications will help inform decisions regarding immunotherapeutic approaches. Suppressive immune cells, such as tumour-associated macrophages and myeloid-derived suppressor cells, form a barrier that shields tumour cells from immune surveillance. The presence of this immunosuppressive barrier in combination with a variety of immune escape mechanisms employed by tumour cells leads to poor tumour immunogenicity. Broad strategies to re-equip the immune system include blockade of suppressive immune cell recruitment to priming cytotoxic effector cells against tumour antigens. While immunotherapeutic strategies are gaining traction for the treatment of cholangiocarcinoma, there is a long road of discovery ahead in order to make meaningful contributions to patient therapy and survival.
近年来，文献资料极大地增进了我们对胆管癌肿瘤免疫微环境的认识和理解。对免疫景观的详细描述定义了新的患者亚型。虽然尚未在临床实践中应用，但这些新的分类将有助于为免疫治疗方法的决策提供信息。抑制性免疫细胞，如肿瘤相关巨噬细胞和髓系来源的抑制性细胞，形成一道屏障，使肿瘤细胞免受免疫监视。这种免疫抑制屏障的存在，加上肿瘤细胞采用的各种免疫逃逸机制，导致肿瘤的免疫原性差。重新装备免疫系统的广泛策略包括阻断抑制性免疫细胞的募集，以激活细胞毒性效应细胞对抗肿瘤抗原。虽然免疫治疗策略在胆管癌的治疗中逐渐受到关注，但在为患者治疗和生存做出有意义的贡献方面，还有很长的路要走。
