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免疫治疗和靶向治疗胆管癌:影像学人工智能研究。

Immunotherapy and targeted therapy for cholangiocarcinoma: Artificial intelligence research in imaging.

机构信息

Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, PR China; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan 646000, PR China.

Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, PR China; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan 646000, PR China.

出版信息

Crit Rev Oncol Hematol. 2024 Feb;194:104235. doi: 10.1016/j.critrevonc.2023.104235. Epub 2024 Jan 12.

Abstract

Cholangiocarcinoma (CCA) is a highly aggressive hepatobiliary malignancy, second only to hepatocellular carcinoma in prevalence. Despite surgical treatment being the recommended method to achieve a cure, it is not viable for patients with advanced CCA. Gene sequencing and artificial intelligence (AI) have recently opened up new possibilities in CCA diagnosis, treatment, and prognosis assessment. Basic research has furthered our understanding of the tumor-immunity microenvironment and revealed targeted molecular mechanisms, resulting in immunotherapy and targeted therapy being increasingly employed in the clinic. Yet, the application of these remedies in CCA is a challenging endeavor due to the varying pathological mechanisms of different CCA types and the lack of expressed immune proteins and molecular targets in some patients. AI in medical imaging has emerged as a powerful tool in this situation, as machine learning and deep learning are able to extract intricate data from CCA lesion images while assisting clinical decision making, and ultimately improving patient prognosis. This review summarized and discussed the current immunotherapy and targeted therapy related to CCA, and the research progress of AI in this field.

摘要

胆管癌(CCA)是一种高度侵袭性的肝胆恶性肿瘤,其发病率仅次肝细胞癌。尽管手术治疗是推荐的治愈方法,但对于晚期 CCA 患者来说并不可行。基因测序和人工智能(AI)最近为 CCA 的诊断、治疗和预后评估开辟了新的可能性。基础研究进一步加深了我们对肿瘤免疫微环境的理解,并揭示了靶向分子机制,导致免疫疗法和靶向疗法在临床上的应用越来越多。然而,由于不同 CCA 类型的病理机制不同,以及一些患者缺乏表达的免疫蛋白和分子靶点,这些治疗方法在 CCA 中的应用具有挑战性。在这种情况下,医学影像中的人工智能已成为一种强大的工具,因为机器学习和深度学习能够从 CCA 病变图像中提取复杂的数据,同时辅助临床决策,最终改善患者的预后。本综述总结和讨论了与 CCA 相关的免疫治疗和靶向治疗,以及 AI 在该领域的研究进展。

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