肺癌相关知识

写在前面

大概想了解下肺癌相关的知识，开此贴做记录，看看后续有没有相关的生信文章思路。

综述

文章名	期刊	影响因子
Lung cancer immunotherapy: progress, pitfalls, and promises	Mol Cancer	37.3

常见治疗手段有surgery, radiation therapy, chemotherapy, and targeted drug therapy 。Medical management易由于治疗抵抗性增加而复发。免疫治疗可生成 immunological memory generation（免疫学记忆），从而克服该缺点。adoptive cell therapy (CAR T, TCR, TIL)将会在本文中被讨论。没有原癌基因驱动的病人通过阻断PD1/PDL1检查点也能取得良好疗效。疫苗联合ICI（免疫检查抑制剂）能实现很好治疗效果。
文章目的：the present article encompasses a detailed overview of the recent developments in the immunotherapeutic landscape in targeting small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Additionally, the review also explores the implication of nanomedicine in lung cancer immunotherapy as well as the combinatorial application of traditional therapy along with immunotherapy regimens. Finally, ongoing clinical trials, significant obstacles, and the future outlook of this treatment strategy are also highlighted to boost further research in the field.
摘要
肺癌根据who的标准可分为非小细胞肺癌（约占85%，还可细分为肺腺癌、肺鳞癌、大细胞癌）与小细胞肺癌（15%）。转移后的肺癌五年生存率低。低剂量CT是诊断金标准，但也存在效率低、假阳性高等问题。传统治疗方式（化疗与放疗）有诸多问题，目前提倡的是针对突变的靶向治疗联合化疗。
非小细胞分为两种亚型，预后都很差（a limited disease SCLC (LD-SCLC) and an extensive disease SCLC (ED-SCLC)），中位生存期只有7-12个月。
肿瘤免疫治疗的目标：The goal of cancer immunotherapy is to elicit (or re-elicit) a cellular immune response, especially the T-cell-mediated tumor-specific antigen (TSA) and tumor-associated antigens (TAA)-directed cytotoxicity that can selectively destroy a tumor 。
免疫调节药物的优点：
The immune-modulatory drugs can also counter cancer cells by increasing the concentration of tumor-specific antibodies, natural killer (NK) cells, dendritic cells (DCs), macrophages (MΦ), and cytokines in the blood plasma。
肺癌对免疫治疗表现不感冒的原因：
lung cancer reduce the overall immunological response by modulating the T-cell mediated cytotoxicity, secretion of immune-suppressive cytokines, and loss of major histocompatibility complex (MHC) expression。
免疫治疗的方式：Immunotherapy treatment types include therapeutic vaccines, immune modulators, autologous cellular therapies, and monoclonal antibodies (mAbs) directed against checkpoint inhibitor signals associated with activated T-cells and/or with cancer cells。

癌型	主要特点	生存期（月）
LUAD	1.独立年龄、性别、吸烟史 2.发展慢,易发现	45
LUSC	1.与吸烟史强相关 2.跟吸烟相关的体细胞基因、通路改变	44
LCC	1.与吸烟史相关 2.非前两种即为该类型	34
若为腺鳞癌仅有26个月	若为非常见的LUAD有95个月

相关的基因突变:
KRAS、ALK、C-MET、RET、BRAF V1E、ROS53、NTRK、TP2 和 ERBB2 （HER40）,肿瘤细胞上特异抗原或新抗原上的基因突变，来躲避t细胞适应性免疫反应。

三信号通路激活经典t细胞：
信号1：APC通过与naive t cell 同源的 TCR 将MHC I 分子上的抗原肽传递给naive t cell。
新号2：interaction of DC-specific CD80/86 and T cells-specific CD28 receptor ，对t细胞的激活很重要
信号3：DCs further secrete pro-inflammatory cytokines (signal 3) to induce T cells toward antigen-specific antitumor response

学习相关的免疫知识

来源：https://www.bilibili.com/video/BV1m54y1v7HM/?spm_id_from=333.337.search-card.all.click&vd_source=74afe31b29c85e8f5a1afbc0d0ec17f0

细胞	主要特点	生存期（月）
B细胞
记忆B细胞	可变成浆细胞
浆细胞	可产生抗体
NK细胞	先天免疫，识别异体，功效较差
T细胞
记忆T细胞	可变
T毒性细胞	特异免疫，杀伤力强
T辅助细胞	生成细胞因子，活化B细胞

细胞	主要特点	生存期（月）
中性粒细胞
嗜酸性粒细胞	杀伤寄生虫
单核细胞
树突细胞	弥合先天与适应免疫
巨噬细胞	清理残渣
肥大细胞	变态反应