乳腺癌患者心理社会因素与免疫功能的相关性

免疫系统在肿瘤进展中有重要作用,心理社会因素也会影响肿瘤的发生、发展.乳腺癌相关心理社会因素主要包括应激性生活事件、应对方式、情绪和个性特征以及社会支持.相关免疫应答效应因素包括T淋巴细胞及其亚群等特异性免疫之间的关系,作为乳腺癌心理治疗的基础,具有重要意义.     

CA153在乳腺癌免疫治疗中的作用

乳腺癌是女性常见的恶性肿瘤,免疫治疗是临床上取得较好效果的治疗手段之一。CA153可在乳腺癌免疫应答中作为特异性抗原激活免疫应答;参与T细胞活化;靶向结合多肽疫苗,增强免疫应答;诱导树突状细胞成熟,清除体内癌细胞等。因此CA153在乳腺癌的免疫应答和治疗中具有重要的作用,可作为乳腺癌免疫治疗的新靶点。     

肿瘤免疫治疗研究进展

免疫系统的功能状态在肿瘤的发生、发展中起到重要作用,对于肿瘤的发生、发展及预后具有重要的影响.基于肿瘤抗原的存在,机体针对肿瘤抗原具有免疫应答,包括特异性和非特异性免疫.然而,肿瘤抗原具有免疫原性低,肿瘤细胞存在免疫逃逸现象,肿瘤患者机体产生的免疫应答常不能抑制肿瘤生长,例如肿瘤抗原的缺失、主要组织相容性复合体(major histocompatibility complex,MHC)类分子表达低下、共刺激信号异常、肿瘤形成过程中产生或分泌的免疫抑制因子(TGF-β、IL-10、IL-33等)以及肿瘤微环境中各种免疫抑制性细胞,包括骨髓来源的抑制性细胞(myeloid derived suppressor cells,MDSC)和调节性T细胞(regulatory T cells,Treg)等[1].     

《中国肿瘤临床》文章推荐:免疫检查点抑制剂相关心肌炎监测与管理中国专家共识(2020版)

免疫检查点抑制剂是近年来肿瘤治疗的重要进展,其主要机制是通过抗体抑制免疫检查点的活性,恢复并提高效应T淋巴细胞特异性识别和杀伤肿瘤细胞的能力,从而增强全身抗肿瘤免疫应答系统的反应。免疫检查点抑制剂适应证已从最初的黑色素瘤扩展到非小细胞肺癌、小细胞肺癌、肾细胞癌、尿路上皮癌、霍奇金淋巴瘤、非霍奇金淋巴瘤、食管癌、胃癌、结直肠癌、肝癌、宫颈癌、头颈部鳞状细胞癌、默克尔细胞癌、皮肤鳞状细胞癌和三阴性乳腺癌等诸多恶性肿瘤.     

乳腺癌疫苗研究面临的机遇和挑战

免疫治疗作为一种极具发展前景的治疗方式给乳腺癌的治疗带来了新的希望。近年来,关于乳腺癌疫苗的研究已陆续开展,将这些研究成果合理、快速地用于临床,为乳腺癌的免疫治疗提供了机遇与挑战。本文重点阐述乳腺癌治疗性疫苗的一些设计策略、临床应用情况,以及未来乳腺癌疫苗研究的发展和应用趋势。随着对肿瘤特异性免疫应答的深入了解、肿瘤特异性抗原的不断发现和鉴定,以及对肿瘤微环境的深入认识,乳腺癌疫苗的研发水平必将得到进一步提高,更好地服务于临床。     

增殖病毒对肿瘤的治疗作用

目的：探讨ＨＥＲ２／ｎｅｕ原癌基因胞外区片段ＤＮＡ免疫诱导的特异性细胞免疫应答及其在体内的抗瘤效应。方法：克隆并构建人ＨＥＲ２／ｎｅｕ原癌基因及其胞外区片段表达载体,分别转染ＳＰ２／０细胞以制备杀伤靶细胞。将质粒ＤＮＡ免疫小鼠,观察其诱导的细胞免疫应答,同时分析免疫动物体内抗瘤效应。结果：体外获得稳定表达ＨＥＲ２／ｎｅｕ基因的ＳＰ２／０靶细胞。目的基因ＤＮＡ免疫后,免疫鼠脾细胞在体外可检测到特异性杀伤作用,体内肿瘤细胞接种后可发现肿瘤结节出现时间延迟,肿瘤生长缓慢。结论： ＨＥＲ２／ｎｅｕ原癌基因胞外区片段ＤＮＡ免疫可诱导出特异细胞免疫应答,并具有一定抗瘤效应。     

肿瘤疫苗与肿瘤免疫治疗研究进展

免疫系统是人体最重要的防御系统之一 ,正常的免疫应答赋予人体抗御感染 ,识别自我与非我 ,及时清除体内衰老、变性的细胞 ,监视突变细胞并将之消灭。肿瘤细胞是人体的变异细胞 ,只要充分调动人体的免疫功能 ,尤其是肿瘤特异性免疫功能 ,就能将肿瘤细胞清除。免疫治疗学的本质就是通过各种手段 ,提高、抑制或调节机体的免疫应答能力 ,最终达到纠正紊乱、治疗疾病的目的 ,其中包括特异性免疫和非特异性免疫。非特异性免疫应答是与生俱来的 ,它的形成并不需要抗原刺激 ,能广泛地针对多种抗原 ,是免疫应答的基础 ,但特异性不强 ,对某种特定抗原…     

双特异性单克隆抗体在乳腺癌免疫治疗中的研究进展

免疫治疗作为乳腺癌的辅助治疗方法近年来已取得很大进展,作为免疫治疗新方法,双特异性单克隆抗体以其优势为治疗乳腺癌开辟了新领域.由于其含有两个能与不同抗原决定簇特异性结合的单克隆抗体片段,它可以同时结合肿瘤细胞相关抗原和血循环中免疫效应细胞的受体,因而能将循环血液中的免疫效应细胞引至肿瘤组织,并诱导免疫效应细胞产生抗肿瘤活性,杀伤肿瘤细胞.     

放疗对机体抗肿瘤免疫效应机制的影响

放疗主要通过对放射野内肿瘤细胞的杀伤使靶区内肿瘤得到控制、可以作用于远处转移灶并能够激活机体抗肿瘤免疫应答。越来越多的研究表明合理的放疗剂量和分割模式能够改善肿瘤微环境,诱导特异性 T 细胞免疫应答,形成原位疫苗并激活机体的抗肿瘤免疫效应。本文重点阐述放疗对机体抗肿瘤免疫效应机制的影响,以及放疗在免疫治疗的辅助下如何发挥抗肿瘤的作用,为恶性肿瘤治疗提供新思路。     

双特异性单克隆抗体在乳腺癌免疫治疗中的研究进展

免疫治疗作为乳腺癌的辅助治疗方法近年来已取得很大进展，作为免疫治疗新方法，双特异性单克隆抗体以其优势为治疗乳腺癌开辟了新领域。由于其含有两个能与不同抗原决定簇特异性结合的单克隆抗体片段，它可以同时结合肿瘤细胞相关抗原和血循环中免疫效应细胞的受体，因而能将循环血液中的免疫效应细胞引至肿瘤组织，并诱导免疫效应细胞产生抗肿瘤活性，杀伤肿瘤细胞。     

Psychoneuroimmunology and the course of breast cancer: An overview the impact of psychosocial factors on progression of breast cancer through immune and endocrine mechanisms

This review focuses upon possible mediators of the frequently noted associations between psychosocial factors and the progression of breast cancer. First, host-related endocrine and immunological processes that may play an important role in the carcinogenesis and progression of breast cancer are summarized. Second, the effects of several endocrines on different components of the immune system that have been shown to be related to the course of breast cancer are addressed. Third, studies examining the effect of psychosocial factors on immune function conducted with breast cancer patients and healthy individuals are described. Based on this review, it can be concluded that causal relations between psychosocial stressors, endocrine and immune processes, and breast cancer progression remain to be elucidated. It can be hypothesized that psychosocial stressors influence the course of breast cancer by modulating endocrine processes which are directly related to tumor growth or indirectly related by decreasing immunologic control over tumor development and metastases. Finally, methodological pitfalls that plague this line of research are summarized and recommendations for future psychoneuroimmunologic research in breast cancer are provided.     

Psychosocial factors in the development and progression of breast cancer

The factors responsible for the genesis of breast cancer remain unclear. Emerging, although controversial, evidence suggests that factors related to life-style, such as dietary fat or alcohol intake, or exposure to various forms of stressors, are associated with mammary tumorigenesis. The possible role of life-style factors in breast cancer is important in light of the fact that mortality to this disease is increasing in most countries and that development of curative therapies for breast cancer has not been forthcoming. Thus, determining the role of life-style factors in the onset and progression of breast cancer, particularly among individuals genetically vulnerable to breast cancer or women with breast cancer in remission, is critical to prevent this disease. We will review the three main hypotheses which have been suggested to link psychosocial factors to the etiology of cancer, emphasizing data obtained through animal models. Interpretation of the existing data suggests that the number of stressful life-events does not predict vulnerability to develop breast cancer or survival from it; a certain level of stress appears to protect from malignancies. The crucial factor affecting tumor growth is the interaction among stress, an individual's personality, and available psychosocial support, and the effect of this interaction on an individual's ability to cope with stress. In addition, other risk factors for breast cancer known to be closely associated with psychosocial factors, namely dietary fat and alcohol consumption, may interact with the effects of psychosocial factors on breast cancer.     

Estrogen-regulated non-reproductive behaviors and breast cancer risk: Animal models and human studies

The possible role of personality patterns and psychosocial factors in breast cancer has been studied extensively, through both human and animal experiments. The data are conflicting, and the conclusions controversial. This review will serve two purposes. First, we present evidence that behavioral patterns most commonly linked to breast cancer risk are at least partly regulated by estrogens. This section will suggest that some estrogen-regulated behaviors may be markers of increased breast cancer risk. Second, we will briefly review recent findings in animals connecting psychosocial factors to cancer. We also will address the plausible biological mechanisms. The literature suggests that estrogens, particularly when exposure occurs during the critical developmental periods, such as in utero, puberty, pregnancy, and menopause, influence affective behaviors and increase breast cancer risk. The affective behaviors include depression, aggression, and alcohol intake. Thus, psychosocial and personality factors do not necessarily have a direct impact on breast cancer risk; instead, estrogens have a dual effect on behavior and on the breast.     

The Relationship Between Psychosocial Stressors and Breast Cancer Biology

Psychosocial stressors have been firmly linked to cardiovascular, immune, and metabolic disease risk through their effects on human physiology. An association with breast cancer risk has also been hypothesized, with both immune and endocrine-mediated mechanisms postulated to link stress to breast cancer biology. Several epidemiologic studies have been performed in an effort to better define the potential association between psychosocial stressors and breast cancer risk. However, despite large prospective studies, the question of whether or not psychosocial stress influences the risk and/or progression of breast cancer remains controversial. From an epidemiologic standpoint, evidence that chronic stress is linked to increased incidence of breast cancer is mixed, whereas targeted intervention trials suggest that reducing chronic stressors diminishes the risk of recurrence. Experimental approaches using animal studies have also yielded conflicting results depending on the model used. Nevertheless, the experimental studies offer valuable insights into environmental stressors and their potential mechanisms for altering the biology of well-defined breast cancer models. The ultimate goal of studying psychosocial stress and breast cancer biology is to identify the interacting mechanisms linking stress physiology to cancer and thereby to modify breast cancer risk factors.     

Psychosocial factors in breast cancer and their possible impact upon prognosis

Breast cancer is the most common cancer form in women. Numerous biological factors have now been identified and accepted as important risk factors and prognosticators. Psychosocial factors are also considered to be of probable importance. A review of the literature studying these factors reveals major methodological problems in evaluating data: small sample size, retrospective design, lack of cross-referencing for other important factors, cross-sectional studies instead of longitudinal studies, and insufficient statistical analysis. Regarding psychosocial factors, some of the most valid studies indicate that the risk of getting breast cancer may be connected with difficulties in expressing feelings, especially ones of aggression; while coping strategy, amount of stress, and level of activity, seem to be of possible influence to the prognosis. A possible connection between psyche and the immunological system has been proposed, but there has been little data so far. Although a series of studies have shown some influence of psychosocial factors on breast cancer, the methodological problems are so large as to leave open the question whether psychosocial factors have any impact upon the disease.     

肠道菌群与乳腺癌相关性研究进展

在最新发布的全球癌症报告中，乳腺癌发病率呈现逐年升高的趋势，跃居女性癌症发病率第一位，乳腺癌的防治成为重中之重。其发生受多种因素的影响，近年随着人类基因组计划的完成，肠道菌群相关基因被发现与多种疾病发生发展相关，并通过影响雌激素水平、免疫功能、乳房局部组织菌群等过程参与乳腺癌的多个病理过程，本文就近几年国内外文献探讨肠道菌群与乳腺癌之间的相关性及机制进行总结并作一综述，深入认识二者间联系，以制定新的乳腺癌防治策略。     

Predictors of quality of life in newly diagnosed melanoma and breast cancer patients.

BACKGROUND: Quality of life (QoL) is a multidimensional construct, and several psychosocial and medical factors can predict a patient's QoL. We investigated the impact of factors in the psychological stress processes on QoL 3 months after diagnosis of melanoma or breast cancer. PATIENTS AND METHODS: In consecutive melanoma and breast cancer patients with localized disease, cancer-specific social support, coping with cancer, personality trait anger expression, non-cancer stress, sociodemographic variables, cancer and treatment variables, and QoL (evaluated as self-reported psychological and physical symptoms, self-perceived QoL, and depression) were assessed with validated quantitative questionnaires. The associations between QoL and the other factors were investigated with multivariate methods. RESULTS: Only a few factors differed between melanoma and breast cancer, in terms of treatment modalities and gender. The amount of received social support was higher among breast cancer patients. The predicting power of psychological stress factors on all the QoL measures was strong, but differed between the treatment groups (surgery only versus adjuvant treatment). Psychosocial factors were the strongest predictors of QoL, not cancer type or treatment. Behavioral Escape-Avoidance coping was associated with worse QoL. However, non-cancer life stresses showed the strongest QoL-decreasing influence. QoL-enhancing factors, including social support, were seen clearly only within the breast cancer patients receiving adjuvant treatment. CONCLUSIONS: QoL of newly diagnosed cancer patients is highly associated with psychosocial factors. Non-cancer life stresses seem to be very important in the QoL of newly diagnosed cancer patients. Adjuvant treatment may comprise supportive psychosocial factors that enhance QoL in cancer.     

High proportion of <Emphasis Type="Italic">BRCA1/2</Emphasis> founder mutations in Hispanic breast/ovarian cancer families from Colombia

Background Physical activity levels among breast cancer survivors are typically low, and knowledge of the correlates of increased physical activity among cancer survivors is limited. The purpose of this study was to examine factors that are associated with physical activity or inactivity among breast cancer survivors. Methods Data from 3088 women participating in the Women’s Healthy Eating and Living (WHEL) Study, collected prior to randomization, were the focus of the current analyses. Self-reports of physical activity levels, quality of life, depression, and dietary intakes were collected. Pearson correlation analyses were employed to examine the associations among these variables, and multiple regression analyses were performed to examine the relationship between selected health behaviors and physical activity levels, after controlling for demographic, breast cancer-related, and psychosocial variables. Results Demographic and psychosocial variables were related to physical activity levels (P < 0.001 for all). Cancer treatment type and cancer stage were correlated with survivors’ physical activity levels (P < 0.01), but the associations were no longer significant after controlling for demographic variables. Physical activity levels were strongly associated with other health behaviors, especially dietary intakes (P < 0.001), even after controlling for demographic, cancer-related, and psychosocial factors. Conclusion Low physical activity levels in breast cancer survivors are associated with specific behavioral and other factors, which can be considered as indicators of women at higher risk. Findings of significant differences in physical activity levels based on demographic characteristics suggest the importance of promoting physical activity particularly among breast cancer survivors of ethnic minority or lower education levels.     

Psychosocial issues associated with genetic testing for breast and ovarian cancer risk: an integrative review

The identification of the BRCA1/2 genes, and their possible etiologic relationship with various forms of inherited cancer, has been recognized universally as a cornerstone in the search for cancer's genetic link and has made it possible to identify specific individuals and families who harbor a mutation in one of these predisposition genes. Genetic testing for breast and ovarian cancer susceptibility may pose unanticipated psychological and social problems. Because of the recent availability of predisposition genetic testing, research efforts have begun to investigate factors that may influence an individual's intention to undergo testing and the psychosocial sequelae associated with testing. The purpose of this article is to provide an integrative review of the literature that will delineate what is currently known about the psychosocial issues associated with genetic testing for breast and ovarian cancer risk. Important generalizations from the literature include: (a) a positive test for breast cancer susceptibility may ignite a psychological response similar to the diagnosis of breast cancer itself; (b) there is likely a subset of individuals at increased risk for hereditary breast and ovarian cancer who are also at risk for sustained psychosocial problems; (c) available literature challenges a common notion that only individuals with a positive test result will need psychosocial services; and (d) at-risk individuals are basing health care decisions on genetic testing information, thus they are making important decisions under conditions of uncertainty. Clinical issues and directions for future research were highlighted.     

The impact of psychosocial stress and stress management on immune responses in patients with cancer

The range of psychosocial stress factors/processes (eg, chronic stress, distress states, coping, social adversity) were reviewed as they relate to immune variables in cancer along with studies of psychosocial interventions on these stress processes and immune measures in cancer populations. The review includes molecular, cellular, and clinical research specifically examining the effects of stress processes and stress-management interventions on immune variables (eg, cellular immune function, inflammation), which may or may not be changing directly in response to the cancer or its treatment. Basic psychoneuroimmunologic research on stress processes (using animal or cellular/tumor models) provides leads for investigating biobehavioral processes that may underlie the associations reported to date. The development of theoretically driven and empirically supported stress-management interventions may provide important adjuncts to clinical cancer care going forward.