适应性免疫反应在头颈部鳞状细胞癌发病和治疗中的作用:免疫抑制因子和性别的影响

A. I. Stukan, R. Murashko, N. A. Tsygan, A. Goryainova, O. N. Nefedov, V. Porkhanov
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摘要

近十年来,头颈部鳞状细胞癌发病机制评价的一个明显趋势是认识到免疫反应障碍对疾病表现的影响。本文根据影响癌变因素、性别、患者年龄及伴发疾病的不同,分析了头颈部鳞状细胞癌患者免疫抑制的类型、程度及治疗反应的差异。吸烟和酗酒的头颈部鳞状细胞癌患者CD8+ t淋巴细胞增加,记忆t细胞减少,肿瘤微环境中CD8+ t淋巴细胞的数量比不吸烟和不饮酒的患者少。研究表明,人乳头瘤病毒(Hpv)相关的头颈部鳞状细胞癌患者预后的改善主要是由于外周血中存在针对Hpv E6和E7的抗体,E7特异性CD8+T淋巴细胞和高水平的肿瘤浸润T淋巴细胞。免疫反应类型的性别差异问题被广泛讨论。研究表明,使用免疫反应检查点抑制剂在提高男性生存率方面更有效,而这些药物与化疗联合使用在女性中更有效。此外,在老年癌症患者中,发现了许多与年龄相关的t淋巴细胞功能变化,包括由于胸腺衰老相关的幼稚t淋巴细胞数量减少,记忆细胞和效应细胞的相对数量增加。因此,很明显,免疫抑制类型以及治疗反应因影响因素、性别、患者年龄以及合并症而异。
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Adaptive immune response in pathogenesis and treatment of head and neck squamous cell carcinoma: the influence of immunosuppression factors and gender
An obvious trend of the last decade in head and neck squamous cell carcinoma pathogenesis evaluation is awareness of the impact of immune response disorders on disease manifestation. The review presents an analysis of the differences in the type and degree of immunosuppression, as well as treatment response in head and neck squamous cell carcinoma patients in accordance with influencing carcinogenic factor, gender, age of the patient and concomitant diseases. An increase in CD8+ T-lymphocytes and a decrease of memory T-cells has been evaluated in smoking and alcohol abusing patients with head and neck squamous cell carcinoma, and a smaller number of CD8+ T-lymphocytes were detected in the tumor microenvironment compared to non-smoking and non-drinking patients. Studies have shown that the improved prognosis of patients with human papillomavirus (Hpv) – associated head and neck squamous cell carcinoma is largely due to the presence of antibodies against Hpv E6 and E7, E7-specific CD8+T lymphocytes in periphe ral blood and a high level of tumor-infiltrating T lymphocytes. The issue of gender differences in the type of immune response is widely discussed. It has been shown that the use of immune response checkpoint inhibitors is more effective in improving survival rates in men, and the use of these drugs in combination with chemotherapy is more effective in women. In addition, in elderly cancer patients, numerous age-associated T-lymphocyte’s function changes were revealed, including a decrease in the number of naive T-lymphocytes due to age-related involution of the thymus and an in crease in the relative number of memory cells and effector cells. Thus, it is clear that immunosuppression type, as well as treatment response, differ depending on the influencing factor, gender, age of the patient, as well as comorbidities.
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