肿瘤突变负荷位点检测准确性评价

目的 使用肿瘤突变负荷国家参考品中高置信SNP/Indel位点标准集的参考品,评价肿瘤突变负荷检测试剂盒的位点检测准确性.方法 采用TMB检测试剂盒(可逆末端终止测序法)检测肿瘤突变负荷检测国家参考品中高置信SNP/Indel位点标准集的参考品.首先将DNA片段化处理,进行末端修复、接头连接和文库扩增等步骤后构建文库;...     

Programmed Cell Death Ligand 1 Immunohistochemistry: A Concordance Study Between Surgical Specimen,Biopsy, and Tissue Microarray

BackgroundThe immunohistochemical analysis of programmed cell death ligand 1 (PD-L1) expression in tumor tissue of non–small-cell lung cancer patients has now been integrated in the diagnostic workup. Analysis is commonly done on small tissue biopsy samples representing a minimal fraction of the whole tumor. The aim of the study was to evaluate the correlation of PD-L1 expression on biopsy specimens with corresponding resection specimens.Materials and MethodsIn total, 58 consecutive cases with preoperative biopsy and resected tumor specimens were selected. From each resection specimen 2 tumor cores were compiled into a tissue microarray (TMA). Immunohistochemical staining with the antibody SP263 was performed on biopsy specimens, resection specimens (whole sections), as well as on the TMA.ResultsThe proportion of PD–L1-positive stainings were comparable between the resection specimens (48% and 19%), the biopsies (43% and 17%), and the TMAs (47% and 14%), using cutoffs of 1% and 50%, respectively (P > .39 all comparisons). When the resection specimens were considered as reference, PD-L1 status differed in 16%/5% for biopsies and in 9%/9% for TMAs (1%/50% cutoff). The sensitivity of the biopsy analysis was 79%/82% and the specificity was 90%/98% at the 1%/50% cutoff. The Cohens κ value for the agreement between biopsy and tumor. was 0.70 at the 1% cutoff and 0.83 at the 50% cutoff.ConclusionThe results indicate a moderate concordance between the analysis of biopsy and whole tumor tissue, resulting in misclassification of samples in particular when the lower 1% cutoff was used. Clinicians should be aware of this uncertainty when interpreting PD-L1 reports for treatment decisions.     

肝癌免疫微环境与免疫治疗：研究进展与发展趋势

肝癌微环境主要由肿瘤相关巨噬细胞、肿瘤相关中性粒细胞、骨髓源性抑制细胞、肿瘤相关成纤维细胞和肿瘤浸润性淋巴细胞等细胞组分,以及细胞外基质、细胞因子等非细胞组分组成。免疫微环境在肝癌进程、免疫逃逸和治疗抵抗中发挥重要作用。近期,以调变炎症免疫微环境为基础的免疫治疗取得突破性进展,免疫疗法的出现为肝癌治疗提供了全新的选择,但仍存在客观缓解率较低、不良反应多和耐药问题。因此,深入研究微环境在肝癌发生发展中的作用及探索免疫治疗的未来发展趋势可提高现有治疗手段的应答率,对肝癌精准诊断与治疗有重要的理论价值和临床意义。     

靶向纳米级免疫偶联物诱导检查点抑制剂抗体治疗颅内胶质瘤的可行性实验研究

目的 探讨靶向纳米级免疫偶联物(Nanoscale immunoconjugates,NCI)诱导检查点抑制剂抗体治疗颅内胶质瘤的可行性。方法 无特定病原体级(Specific pathogen free,SPF)级、雌性大鼠168只,随机分为磷酸缓冲盐溶液(Phosphate buffer saline,PBS)组(24只),游离组(72只)及NIC组(72只); 所有大鼠均进行颅内胶质瘤细胞植入,构建颅内胶质瘤大鼠模型; PBS组不进行治疗; 游离组给予T淋巴细胞相关抗原4(Cytotoxic T lymphocyte associated antigen-4,a-CTLA-4)和程序性细胞死亡1(Anti programmed cell death protein-1,a-PD-1)及两者联合注射,每种各24只; NCI组给予纳米级免疫偶联物诱导检查点抑制剂抗体[分别为聚苹果酸/ T淋巴细胞相关抗原4(Polymalic malic acid/ Cytotoxic T lymphocyte associated antigen-4,P/a-CTLA-4)、聚苹果酸/程序性细胞死亡1(Polymalic malic acid/Anti programmed cell death protein-1,P/a-PD-1)及两盒联合注射]注射,每种各24只; 使用荧光素标记法观察不同组大鼠药物血脑屏障穿透效率,比较不同治疗方式大鼠治疗后CD3+T细胞(CD3+Pan T Cells,CD3+)、CD4+,CD8+、调节性T细胞(Regulatory T cells,Treg)、巨噬细胞(MΦ)、自然杀伤细胞(Natural killer cell,NK)细胞、自然杀伤T细胞(Natural killer T cell,NKT)细胞、干扰素γ(Interferon-γ,IFNγ)水平及大鼠CD4+,CD8+增殖活跃程度、生存期。结果 荧光实验显示,NIC组各治疗方式大鼠脑部荧光面积均显著高于游离组及PBS组; NCI各组CD3+、CD4+、CD8+、Treg、CD4+ki67、CD8+ki67、MΦ、M1MΦ、M2MΦ、NK细胞、NKT细胞、IFNγ每孔计数及总体生存期显著高于游离组及PBS组(P<0.05)。结论 NCI诱导检查点抑制剂抗体能促进药物透过血脑屏障,刺激大脑驻留的免疫系统,促使CD8+ T细胞增殖并触发多种免疫细胞因子的释放,增加M1型巨噬细胞的产生,从而协调针对GBM的免疫反应,提高颅内胶质瘤大鼠存活时间。     

自身免疫性垂体炎发病机制的研究进展

自身免疫性垂体炎(AH)是一种罕见的垂体炎性疾病。其临床表现主要以垂体内分泌异常或炎症压迫为特征,典型症状为头痛、视觉受压、多饮、多尿等,并可伴有其他自身免疫性疾病。尽管进行了大量研究,但AH的发病机制尚未完全阐明。因此本文讨论了最近关于自身免疫性垂体炎的潜在机制的发现,以深刻理解AH发生发展的病理生理过程,并可能为AH的诊断和治疗提供新的方向。