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弥漫大B细胞淋巴瘤(DLBCL)是最常见的侵袭性非霍奇金淋巴瘤(NHL)之一,具有显著的生物学与临床异质性。利妥昔单抗联合环磷酰胺、多柔比星、长春新碱及泼尼松(R-CHOP)免疫化疗方案虽能改善DLBCL患者的总体预后,但仍有相当比例的患者出现复发或难治,这提示仅从肿瘤细胞内在异常难以完全解释疾病进展与耐药机制。肿瘤微环境(TME)通过免疫抑制网络与基质重塑,深度参与DLBCL的发生发展、预后分层及治疗应答。在TME中,T细胞耗竭、免疫检查点失衡、调节性T细胞扩增、NK细胞功能受损、树突状细胞数量减少致使抗原呈递不足,以及肿瘤相关巨噬细胞、髓源性抑制性细胞和肿瘤相关中性粒细胞介导的免疫抑制,共同推动了免疫逃逸的发生;癌相关成纤维细胞、细胞外基质重塑以及血管生成信号塑造了免疫排斥和治疗耐受的生态位。此外,针对新型免疫检查点、巨噬细胞吞噬抑制、癌相关成纤维细胞信号轴以及表观遗传修饰的干预策略,为通过联合治疗重塑肿瘤微环境、实现DLBCL的精准治疗提供了新路径。
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基本信息:
中图分类号:R733.1
引用信息:
[1]崔文丽,郭婷婷,杨波,等.弥漫大B细胞淋巴瘤肿瘤微环境的研究进展[J].新疆医科大学学报,2026,49(03):317-323.
基金信息:
国家自然科学基金地区科学基金项目(82360046); 天山英才医药卫生高层次人才培养计划(TSYC202301A009)
2026-03-15
2026-03-15