Tan S H, Li W M, Tian P W
Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2024 Jul 12;47(7):668-675. doi: 10.3760/cma.j.cn112147-20240119-00039.
Malignant pleural effusion (MPE) can be secondary to various advanced malignant tumors. Although systemic anti tumor therapy may be effective in primary tumors, it cannot reduce the accumulation of MPE in proportion of the patients. The interaction of tumor cells, immune cells, and mesenchymal cells, as well as the abnormal proliferation of tumor-associated blood vessels, together create an immunosuppressive microenvironment for MPE, which promotes the abnormal proliferation of tumor cells and the accumulation of MPE. With the in-depth study of the tumor microenvironment, the application of local systemic anti-tumor therapy with local intrathoracic application of immune checkpoint inhibitors, immune cells, cytokines, and gene-mediated cytotoxic immunotherapy are able to alleviate the immunosuppressive tumor microenvironment and inhibit the accumulation of MPE. This article aimed to describe the tumor microenvironment in MPE and provide clues for identifying novel therapeutic targets.
恶性胸腔积液(MPE)可能继发于各种晚期恶性肿瘤。尽管全身抗肿瘤治疗对原发性肿瘤可能有效,但并不能使所有患者的MPE积聚量相应减少。肿瘤细胞、免疫细胞和间充质细胞之间的相互作用,以及肿瘤相关血管的异常增殖,共同为MPE营造了一个免疫抑制微环境,促进了肿瘤细胞的异常增殖和MPE的积聚。随着对肿瘤微环境研究的深入,通过胸腔内局部应用免疫检查点抑制剂、免疫细胞、细胞因子以及基因介导的细胞毒性免疫疗法等局部全身抗肿瘤治疗,能够缓解免疫抑制性肿瘤微环境并抑制MPE的积聚。本文旨在描述MPE中的肿瘤微环境,并为确定新的治疗靶点提供线索。