Prehn R T, Prehn L M
Department of Pathology, School of Medicine, University of Washington, Seattle, USA.
Medicina (B Aires). 1996;56 Suppl 1:65-73.
A moderate antitumor immune reaction is optimal for tumor growth and most (perhaps all) untransplanted tumors, rather than being inhibited, are probably dependent, at least early in their progression, upon the immune reaction. Some tumors, as for example most human skin tumors, have a higher incidence in immunodepressed patients than they do in the general population. This could mean that the normal immune reaction usually inhibits the growth of these tumors. More probably, the increased incidence in immuno-depressed heart and kidney transplant patients is caused by a lowering of a tumor-stimulatory immune reaction to a level that is even more stimulatory. Other tumors, such as human mammary tumors, have, in contrast to the skin tumors, a lower than expected incidence in immunodepressed patients. Mammary tumors are postulated to possess, on average, a low immunogenicity that arouses an immune reaction that is usually equal to or less than that required for optimal tumor growth; a further lowering of the reaction, as occurs in heart or kidney transplant patients, thus results in a lowered tumor incidence. In such patients, an immunostimulating adjuvant or vaccine might, we predict, sometimes accelerate rather than inhibit tumor growth.
适度的抗肿瘤免疫反应对于肿瘤生长而言是最佳的，并且大多数（或许所有）未经移植的肿瘤，至少在其进展的早期阶段，并非受到抑制，反而可能依赖于免疫反应。一些肿瘤，例如大多数人类皮肤肿瘤，在免疫抑制患者中的发病率高于普通人群。这可能意味着正常的免疫反应通常会抑制这些肿瘤的生长。更有可能的是，免疫抑制的心脏和肾脏移植患者中发病率的增加是由于肿瘤刺激免疫反应降低到了一个更具刺激性的水平。与皮肤肿瘤相反，其他肿瘤，如人类乳腺肿瘤，在免疫抑制患者中的发病率低于预期。据推测，乳腺肿瘤平均具有较低的免疫原性，引发的免疫反应通常等于或小于肿瘤最佳生长所需的免疫反应；因此，如在心脏或肾脏移植患者中发生的那样，免疫反应的进一步降低会导致肿瘤发病率降低。我们预测，在这类患者中，免疫刺激佐剂或疫苗有时可能会加速而非抑制肿瘤生长。
