RNF43 p.G659fs 通过 PI3K/AKT/mTOR 信号通路和 HLA-E 上调导致 MSI-high 结直肠癌中 NK 细胞功能障碍
RNF43 p.G659fs leads to natural killer cell dysfunction in MSI-high colorectal cancer through PI3K/AKT/mTOR signaling and HLA-E up-regulation.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Er:YAG laser-PDT combined with anti- programmed cell death protein-1 for refractory oral potential malignant disorders following oral squamous cell carcinoma surgery.
Er:YAG laser-PDT combined with anti- programmed cell death protein-1 for refractory oral potential malignant disorders following oral squamous cell carcinoma surgery.
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口腔潜在恶性疾病(OPMD)恶变和复发风险较高。本病例报告介绍一种新治疗策略:对侧接受口腔鳞状细胞癌(OSCC)手术后,患者右下牙龈出现难治性OPMD,接受钬铬铥钪镓石榴石(Er:YAG)激光辅助光动力治疗(Er:YAG-PDT)联合抗程序性细胞死亡蛋白1(抗PD-1)免疫治疗。单独PDT初期疗效有限;加入Er:YAG激光预处理后,病灶显著消退,最终完全清除。6个月随访显示局部病灶控制良好。患者外周血分析发现NK细胞水平升高、调节性T(Treg)细胞比例下降,提示适应性免疫活化;CD8 T细胞水平相近,说明免疫稳态得以维持。本病例提示Er:YAG-PDT联合抗PD-1治疗OPMD可能具有潜力,同时强调高危患者仍需优化监测和多模式策略以预防复发。
Oral potential malignant disorders (OPMDs) have a high risk of malignant transformation and recurrence. This case reports describes a novel therapeutic strategy of Er:YAG laser-assisted photodynamic therapy (Er:YAG-PDT) combined with anti-programmed death protein-1 (anti-PD-1) immunotherapy for a patient with refractory OPMDs in the right lower gingiva following oral squamous cell carcinoma (OSCC) surgery on the contralateral side. Initial PDT alone showed limited efficacy, but after integrating Er:YAG laser pretreatment, the patient achieved significant lesion regression, with a complete final clearance.
The 6-month follow-up showed good local lesion control in the patient peripheral blood analysis revealed elevated natural killer (NK) cell level and reduced regulatory T (Treg) cell percentage, suggesting activated adaptive immunity, while similar CD8 T cell levels indicated maintained immune homeostasis. This case report highlights the potential of combined Er:YAG-PDT and anti-PD-1 therapy for OPMDs, while emphasizing the need for optimized monitoring and multi-modal strategies to prevent recurrence in high-risk patients.
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