{"id":35722,"date":"2020-10-27T00:55:42","date_gmt":"2020-10-26T16:55:42","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=35722"},"modified":"2020-09-29T11:23:03","modified_gmt":"2020-09-29T03:23:03","slug":"%e8%83%b0%e8%87%9f%e7%99%8c%e7%9a%84%e7%af%a9%e6%aa%a2%e8%88%87%e5%85%8d%e7%96%ab%e7%99%82%e6%b3%95","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=35722","title":{"rendered":"\u80f0\u81df\u764c\u7684\u7be9\u6aa2\u8207\u514d\u75ab\u7642\u6cd5"},"content":{"rendered":"

\u80f0\u81df\u764c\uff08\u80f0\u817a\u764c\u7d04\u536095%\uff09\u662f\u4e00\u7a2e\u9810\u5f8c\u6975\u5dee\u7684\u81f4\u547d\u7684\u60e1\u6027\u816b\u7624\uff0c\u7be9\u6aa2\u53ca\u6cbb\u7642\u65b9\u6cd5\u662f\u80f0\u81df\u764c\u65e9\u671f\u8a3a\u65b7\u53ca\u9810\u5f8c\u826f\u597d\u7684\u95dc\u9375\u6027\u56e0\u7d20\u3002\u73fe\u884c\u7684\u7be9\u6aa2\u65b9\u6cd5\u662f\u96fb\u8166\u65b7\u5c64\u6383\u63cf\u3001\u78c1\u5171\u632f\u986f\u5f71\u3001\u6b63\u5b50\u767c\u5c04\u65b7\u5c64\u6383\u63cf\u53ca\u5167\u8996\u93e1\u8d85\u97f3\u6ce2\uff1b\u6700\u6709\u6548\u7684\u6cbb\u7642\u65b9\u6cd5\u662f\u624b\u8853\u5207\u9664\uff0c\u5176\u4ed6\u7642\u6cd5\uff08\u5982\u5316\u5b78\u6cbb\u7642\u3001\u653e\u5c04\u6cbb\u7642\u53ca\u6a19\u9776\u6cbb\u7642\uff09\u5247\u4f5c\u70ba\u8f14\u52a9\u6cbb\u7642\u4e4b\u7528\u3002\u6211\u5011\u5728\u672c\u6587\u4e2d\uff0c\u5c07\u4ecb\u7d39\u80f0\u81df\u764c\u7684\u50b3\u7d71\u53ca\u65b0\u8208\u7684\u7be9\u6aa2\u65b9\u6cd5\uff0c\u4e26\u63a2\u7d22\u80f0\u81df\u764c\u7684\u514d\u75ab\u7642\u6cd5\uff0c\u4e26\u8a55\u4f30\u5176\u4f5c\u7528\u53ca\u6709\u6548\u6027\u3002<\/strong><\/span><\/p>\n

\"\"
\u5716\u7247\u4f86\u6e90\uff1aPixabay<\/figcaption><\/figure>\n

\u64b0\u6587\uff0f\u9673\u6df5\u9293<\/strong><\/p>\n

\u80f0\u81df\u764c\u7684\u7be9\u6aa2\u65b9\u6cd5<\/strong><\/span><\/p>\n

\u5168\u7403\u80f0\u81df\u764c\u7684\u767c\u751f\u7387\u6b63\u5728\u9010\u6f38\u4e0a\u5347\uff0c\u5bc6\u5207\u6ce8\u610f\u80f0\u817a\u7684\u7e7c\u767c\u5fb5\u8c61\uff08\u5982\u80f0\u7ba1\u64f4\u5f35\u3001\u7a81\u7136\u7684\u80f0\u7ba1\u53e3\u5f91\u8b8a\u5316\u53ca\u5be6\u8cea\u6027\u840e\u7e2e\u7b49\uff09\u5c0d\u80f0\u81df\u764c\u7684\u7be9\u6aa2\u5341\u5206\u91cd\u8981\uff0c\u4e0b\u5217\u7be9\u6aa2\u65b9\u6cd5\u5df2\u7528\u65bc\u80f0\u817a\u764c\u7684\u65e9\u671f\u8a3a\u65b7\uff1a<\/p>\n

1. \u96fb\u8166\u65b7\u5c64\u6383\u63cf\uff08Computed tomography, CT\uff09\u53ca\u78c1\u5171\u632f\u986f\u5f71\uff08Magnetic resonance imaging, MRI\uff09\uff1aCT\u662f\u7be9\u6aa2\u80f0\u817a\u764c\u7b2c\u4e00\u7dda\u65b9\u6cd5\uff0c\u80f0\u81bd\u7ba1MRI\u5247\u662f\u7b2c\u4e8c\u7dda\u65b9\u6cd5\u3002CT\u548cMRI\u5c0d\u80f0\u817a\u764c\u7684\u6aa2\u6e2c\u5747\u5177\u9ad8\u9748\u654f\u5ea6\uff08\u5206\u5225\u662f96\uff05\u548c5\uff05\uff09\uff0c\u5728\u8a55\u4f30\u816b\u7624\u53ef\u5207\u9664\u6027\u4e0a\uff0cCT\u6e96\u78ba\u7387\u5247\u512a\u65bcMRI\uff08\u5206\u5225\u662f86.8\uff05\u548c78.9\uff05\uff09\u3002<\/p>\n

2.\u6b63\u5b50\u767c\u5c04\u65b7\u5c64\u6383\u63cf\uff08Positron emission tomography, PET\uff09\/\u96fb\u8166\u65b7\u5c64\u6383\u63cf\uff08CT\uff09\uff1aPET\u4f7f\u7528\u653e\u5c04\u6027\u768418<\/sup>F-fluoro-2-deoxy-D-glucose \u4f5c\u70ba\u8ffd\u8e2a\u5291\uff0c\u4e26\u7d2f\u7a4d\u5728\u7cd6\u9175\u89e3\u4ee3\u8b1d\uff08glycolytic metabolism\uff09\u589e\u52a0\u7684\u7d30\u80de\u4e2d\uff0c\u4f46PET \/ CT\u5c0d\u80f0\u817a\u764c\u7684\u8a3a\u65b7\u7684\u529f\u80fd\u5c1a\u4e0d\u660e\u78ba\uff0c\u4ecd\u7121\u6cd5\u53d6\u4ee3CT\u3002<\/p>\n

3.\u5167\u8996\u93e1\u8d85\u97f3\u6ce2\uff08Endoscopic ultrasound, EUS\uff09\uff1a\u5167\u8996\u93e1\u7684\u9060\u7aef\u63a5\u4e0a\u8d85\u97f3\u6ce2\u63a2\u982d\uff0c\u4f9d\u63a2\u982d\u7684\u7a2e\u985e\u518d\u5206\u6210\u74b0\u72c0\u548c\u7dda\u6027\u6383\u7784\u578b\u5169\u7a2e\uff0c\u85c9\u9ad8\u983b\u7387\uff085\u81f320MHz\uff09\u5e36\u4f86\u7684\u89e3\u50cf\u529b\uff0c\u53ef\u4ee5\u5075\u6e2c\u5230CT\u6216MRI\u770b\u4e0d\u5230\u4e14\u5c0f\u65bc2\u516c\u5206\u7684\u816b\u7624\uff0c\u800c\u4e14\u5f69\u8272\u591a\u666e\u52d2\uff08color doppler\uff09\u53ef\u4f7f\u8840\u7ba1\u7d50\u69cb\u6210\u50cf\uff0c\u4f46EUS\u64cd\u4f5c\u904e\u7a0b\u8f03\u8907\u96dc\u4e14\u5c0d\u53d7\u6aa2\u8005\u6703\u6709\u4e00\u5b9a\u7a0b\u5ea6\u4e4b\u98a8\u96aa\uff0c\u4e00\u822c\u4e0d\u4f5c\u70ba\u7b2c\u4e00\u7dda\u7684\u7be9\u6aa2\u65b9\u6cd5\u3002<\/p>\n

\u4e0b\u5217\u65b0\u8208\u6280\u8853\u53ef\u6aa2\u6e2c\u60e1\u6027\u816b\u7624\u524d\u9ad4\uff08precursor\uff09\uff0c\u800c\u6709\u7528\u65bc\u65e9\u671f\u8a3a\u65b7\u80f0\u81df\u764c\u7684\u6f5b\u529b\uff0c\u4f46\u76ee\u524d\u4ecd\u8655\u65bc\u81e8\u5e8a\u524d\u958b\u767c\u968e\u6bb5\uff0c\u5be6\u969b\u6548\u7528\u53ca\u53ef\u9760\u6027\u4ecd\u9808\u5728\u66f4\u5927\u898f\u6a21\u7684\u81e8\u5e8a\u8a66\u9a57\u4f5c\u9a57\u8b49\u3002<\/p>\n

1.\u96fb\u5f71\u7d1a\u7e6a\u88fd(Cinematic rendering<\/em>)\uff1a\u5c07CT\u8207MRI\u7684\u6578\u64da\u8f49\u5316\u62103D\u5f71\u50cf\uff0c\u903c\u771f\u7684\u96fb\u5f71\u6e32\u67d3\u5149\u5efa\u6a21\u5177\u6709\u589e\u5f37\u7a7a\u9593\u95dc\u4fc2\u8a55\u4f30\u7684\u6548\u679c\uff0c\u6539\u5584\u4e86\u80f0\u81df\u816b\u7624\u8207\u76f8\u9130\u8108\u7ba1\u7cfb\u7d71\u4e4b\u9593\u7684\u53ef\u89c0\u5bdf\u6027\uff08visualization\uff09\uff0c\u53ef\u80fd\u6709\u52a9\u65bc\u78ba\u5b9a\u816b\u7624\u7684\u53ef\u5207\u9664\u6027\u548c\u624b\u8853\u524d\u8a08\u756b\u3002<\/p>\n

2.\u5f71\u50cf\u7d44\u5b78\uff08Radiomics\uff09\uff1a\u64f7\u53d6CT\u3001MRI\u53caPET\u91ab\u5b78\u5f71\u50cf\u5340\u57df\u6578\u767e\u500b\u5b9a\u91cf\u5f71\u50cf\u7279\u5fb5\uff0c\u518d\u5c0d\u9019\u4e9b\u7279\u5fb5\u9032\u884c\u7be9\u9078\u548c\u5206\u6790\u7684\u4e00\u7a2e\u9ad8\u901a\u91cf\u5b9a\u91cf\u5206\u6790\u65b9\u6cd5\uff0c\u7528\u65bc\u63cf\u8ff0\u80f0\u81df\u816b\u7624\u751f\u7269\u5b78\u7279\u5fb5\u548c\u7570\u8cea\u6027\u7b49\u8cc7\u8a0a\u3002<\/p>\n

3.\u6a5f\u5668\u5b78\u7fd2\uff08Machine learning\uff09\uff1a\u5c6c\u65bc\u4eba\u5de5\u667a\u6167\u7684\u4e00\u74b0\uff0c\u662f\u4e00\u7a2e\u7d93\u7531\u6a5f\u5668\u81ea\u4e3b\u5b78\u7fd2\u4e26\u589e\u5f37\u7684\u6f14\u7b97\u6cd5\uff0c\u900f\u904e\u8ff4\u6b78\u5206\u6790\uff0c\u6a5f\u5668\uff08\u96fb\u8166\uff09\u80fd\u5f9e\u4e00\u7fa4\u6578\u64da\u4e2d\u627e\u51fa\u898f\u5f8b\u4e26\u4f5c\u51fa\u9810\u6e2c\uff0c\u7576\u8f38\u5165\u7684\u6578\u64da\u8d8a\u591a\uff0c\u6f14\u7b97\u6cd5\u4e5f\u6703\u4f5c\u51fa\u66f4\u7cbe\u6e96\u7684\u5206\u6790\u3002\u96fb\u8166\u53ef\u63d0\u4f9b\u8a13\u7df4\u6578\u64da\u7d44\uff0c\u4e26\u64f7\u53d6\u53ef\u5c0d\u80f0\u81df\u75c5\u8b8a\u985e\u578b\u9032\u884c\u5206\u985e\uff08\u826f\u6027\u8207\u60e1\u6027\uff09\u7684\u6210\u50cf\u7279\u5fb5\u3002<\/p>\n

4.\u5206\u5b50\u986f\u5f71\uff08Molecular imaging\uff09\uff1a\u4f7f\u7528\u7279\u5b9a\u7684\u8ffd\u8e2a\u5291\u4f86\u6aa2\u6e2c\u80f0\u817a\u764c\u5df2\u7d93\u5728\u52d5\u7269\u6a21\u5f0f\u4e2d\u958b\u767c\u51fa\u4f86\uff0c\u80f0\u817a\u764c\u4e2d\u8a31\u591a\u5206\u5b50\u6a19\u9776\uff08target\uff09\u6703\u904e\u5ea6\u8868\u9054\uff0c\u6a19\u9776\u4f5c\u7528\u5230\u9019\u4e9b\u9776\u6a19\u7684\u653e\u5c04\u6027\u8ffd\u8e2a\u5291\u80fd\u6aa2\u6e2c\u690d\u5165\u5c0f\u9f20\u7684\u4eba\u985e\u80f0\u817a\u764c\u7570\u7a2e\u79fb\u690d\u7269\uff08xenografts\uff09\u3002\u56e0\u6b64\uff0c\u5206\u5b50\u6210\u50cf\u4e0d\u50c5\u6709\u671b\u6aa2\u6e2c\u80f0\u817a\u764c\uff0c\u800c\u4e14\u6709\u671b\u7528\u65bc\u80f0\u817a\u764c\u7684\u6a19\u9776\u6cbb\u7642\uff08target therapy\uff09\u3002<\/p>\n

\u80f0\u81df\u764c\u7684\u514d\u75ab\u7642\u6cd5<\/strong><\/span><\/p>\n

\u5df2\u6709\u8a31\u591a\u81e8\u5e8a\u8a66\u9a57\u8a66\u5716\u8a55\u4f30\u80f0\u81df\u764c\u514d\u75ab\u6cbb\u7642\u7684\u6709\u6548\u6027\uff0c\u800c\u76ee\u524d\u9019\u4e9b\u7814\u7a76\u5747\u672a\u80fd\u6539\u8b8a\u81e8\u5e8a\u7d50\u679c\uff08clinical outcome\uff09\uff0c\u4f46\u662f\u63a1\u7528\u514d\u75ab\u7642\u6cd5\u8207\u5176\u4ed6\u7642\u6cd5\u7d50\u5408\u7684\u7d44\u5408\u5f0f\u65b9\u6cd5\u6642\uff0c\u4f3c\u4e4e\u6709\u589e\u52a0\u53cd\u61c9\u7387\u7684\u5354\u540c\u6548\u61c9\u3002\u4e0b\u5217\u662f\u7814\u7a76\u4e2d\u7684\u514d\u75ab\u7642\u6cd5\uff1a<\/p>\n

1.\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\uff08Immune check point inhibitor\uff09\uff1a\u514d\u75ab\u6aa2\u67e5\u9ede\u963b\u65b7\u5291\uff08\u5982anti-CTLA-4\u3001anti-PD-1\u3001anti-PD-L1\uff09\u96d6\u7136\u5728\u67d0\u4e9b\u60e1\u6027\u816b\u7624\u4e2d\u986f\u793a\u51fa\u7642\u6548\uff0c\u4f46\u5728\u5927\u591a\u6578\u80f0\u81df\u764c\u7b2c\u4e00\u3001\u4e8c\u671f\u7684\u81e8\u5e8a\u8a66\u9a57\u5747\u672a\u80fd\u8b49\u660e\u6709\u4efb\u4f55\u7642\u6548\u3002\u5118\u7ba1\u5982\u6b64\uff0c\u7d50\u5408\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u548c\u653e\u5c04\u6cbb\u7642\u548c\/\u6216\u5316\u5b78\u6cbb\u7642\u7684\u7d44\u5408\u7642\u6cd5\u5df2\u521d\u6b65\u986f\u793a\u51fa\u6b63\u9762\u7684\u7d50\u679c\u3002<\/p>\n

2.\u6cbb\u7642\u6027\u764c\u75c7\u75ab\u82d7\uff08Therapeutic cancer vaccine\uff09\uff1a\u6cbb\u7642\u6027\u764c\u75c7\u75ab\u82d7\uff08\u5305\u62ec\u5168\u7d30\u80de\u3001\u6a39\u7a81\u7d30\u80de\u3001DNA\u53ca\u80bd\u75ab\u82d7\uff09\u53ef\u6fc0\u767c\u514d\u75ab\u539f\u6027\u764c\u75c7\u6297\u539f\u5448\u905e\u7d66\u514d\u75ab\u7cfb\u7d71\uff0c\u6709\u6f5b\u529b\u6fc0\u6d3b\u764c\u75c7\u6297\u539f\u7279\u7570\u6027\u6bd2\u6bba\u6027\u6dcb\u5df4\u7d30\u80de\uff08cytotoxic T lymphocyte\uff09\u53ca\u5f15\u767c\u96a8\u5f8c\u7684\u6297\u764c\u514d\u75ab\u53cd\u61c9\u3002<\/p>\n

3.\u904e\u7e7c\u6027\u7d30\u80de\u8f49\u79fb\uff08Adoptive cell transfer, ACT\uff09\uff1a\u6536\u96c6\u60a3\u8005\u81ea\u8eab\u7684\u816b\u7624\u6297\u539f\u7279\u7570\u6027T\u7d30\u80de\u5f8c\uff0c\u5728\u9ad4\u5916\u9032\u884c\u57fa\u56e0\u6539\u9020\u4e26\u52a0\u4ee5\u57f9\u990a\u589e\u6b96\uff0c\u518d\u5c07T\u7d30\u80de\u91cd\u65b0\u8f49\u690d\u56de\u60a3\u8005\u9ad4\u5167\uff0c\u7528\u4ee5\u589e\u5f37\u514d\u75ab\u529b\u548c\u6539\u5584\u514d\u75ab\u53cd\u61c9\uff0c\u5d4c\u5408\u6297\u539f\u53d7\u9ad4T\u7d30\u80de\uff08chimeric antigen receptor T cells, CART\uff09\u6cbb\u7642\u662f\u81e8\u5e8a\u4e0a\u6700\u767c\u9054\u7684ACT\u985e\u578b\u3002<\/p>\n

4.\u6fc0\u6d3b\u6027\u514d\u75ab\u6cbb\u7642\uff08Agonistic immunotherapy\uff09\uff1a\u6297\u539f\u5448\u73fe\u7d30\u80de\uff08antigen presentation cell, APC\uff09\u6fc0\u6d3b\u5291\u548cT\u7d30\u80de\u6fc0\u6d3b\u5291\u662f\u5169\u7a2e\u6b63\u5728\u7814\u7a76\u7684\u65b9\u6cd5\u3002\u6fc0\u6d3b\u6027CD40\u6cbb\u7642\u53ef\u6a21\u64ecT\u7d30\u80de\u5354\u52a9\u4e26\u4f7fAPC\u7372\u5f97\u8a31\u53ef\uff0c\u4f7fAPC\u66f4\u6709\u6548\u5730\u5c07\u6297\u539f\u5448\u905e\u7d66T\u7d30\u80de\u4e14\u6fc0\u6d3bT\u7d30\u80de\u3002\u6fc0\u6d3b\u6027CD40\u55ae\u4e00\u6cbb\u7642\u8207gemcitabine\u53ef\u6fc0\u6d3b\u5de8\u566c\u7d30\u80de\u53bb\u6bba\u6b7b\u764c\u7d30\u80de\uff0c\u4e26\u5728\u7b2c\u4e00\u671f\u81e8\u5e8a\u8a66\u9a57\u4e2d\u986f\u793a\u51fa\u7642\u6548\u3002<\/p>\n

5.\u9aa8\u9ad3\u578b\u514d\u75ab\u6cbb\u7642\uff08Myeloid-based immunotherapy\uff09\uff1a\u80f0\u817a\u764c\u7684\u7570\u5e38\u514d\u75ab\u53cd\u61c9\u6709\u90e8\u5206\u7531\u514d\u75ab\u6291\u5236\u6027\u7684\u9aa8\u9ad3\u4f86\u8abf\u7bc0\uff0c\u6291\u5236\u9aa8\u9ad3\u5373\u53ef\u6291\u5236\u816b\u7624\u3002\u9aa8\u9ad3\u7531\u7d30\u80de\u6fc0\u7d20\uff08chemokine\uff09\u3001\u8da8\u5316\u6fc0\u7d20\uff08chemokine\uff09\u53ca\u8a0a\u865f\u5206\u5b50\uff08signaling molecule\uff09\u4f86\u63a7\u5236\uff0c\u9019\u4e9b\u5206\u5b50\u6b63\u53ef\u4f5c\u70ba\u6cbb\u7642\u7684\u6a19\u9776\u3002<\/p>\n

6.\u57fa\u8cea\u8abf\u63a7\u7684\u514d\u75ab\u6cbb\u7642\uff08Stroma-modulating immunotherapy\uff09\uff1a\u80f0\u817a\u764c\u7684\u589e\u751f\u57fa\u8cea\u662f\u514d\u75ab\u6291\u5236\u6027\u816b\u7624\u5fae\u74b0\u5883\uff08immunosuppressive tumor microenvironment\uff09\u7684\u95dc\u9375\u7d44\u6210\u90e8\u5206\uff0c\u4e5f\u662f\u6709\u6548\u6cbb\u7642\u7684\u969c\u7919\uff0c\u96d6\u7136\u6a19\u9776\u4f5c\u7528\u5230\u57fa\u8cea\u662f\u5426\u5747\u70ba\u6709\u76ca\u4ecd\u5b58\u6709\u722d\u8b70\uff0c\u4f46\u65e9\u671f\u968e\u6bb5\u7684\u7814\u7a76\u5df2\u958b\u59cb\u8b49\u660e\u8abf\u63a7\u57fa\u8cea\u7684\u6cbb\u7642\u6f5b\u529b\u3002<\/p>\n

 <\/strong><\/p>\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong><\/p>\n

1. Li HY, Cui ZM, Chen J, Guo XZ, Li YY. Pancreatic cancer: diagnosis and treatments. Tumour Biol. 2015 Mar;36(3):1375-84. doi: 10.1007\/s13277-015-3223-7. Epub 2015 Feb .
\n2. Chu LC, Goggins MG, Fishman EK. Diagnosis and detection of pancreatic cancer. Cancer J. 2017 Nov\/Dec;23(6):333-342. doi: 10.1097\/PPO.0000000000000290.
\n3.Morrison AH, Byrne KT, Vonderheide RH. Immunotherapy and prevention of pancreatic cancer. Trends Cancer. 2018 Jun;4(6):418-428. doi: 10.1016\/j.trecan.2018.04.001. Epub 2018 Apr 30.
\n4. Sunami Y, Kleeff J. Immunotherapy of pancreatic cancer. Prog Mol Biol Transl Sci. 2019;164:189-216. doi: 10.1016\/bs.pmbts.2019.03.006. Epub 2019 Mar 22.
\n5.Schizas D, Charalampakis N, Kole C, Economopoulou P, Koustas E, Gkotsis E, Ziogas D, Psyrri A, Karamouzis MV. Immunotherapy for pancreatic cancer: A 2020 update. Cancer Treat Rev. 2020 Jun;86:102016.doi: 10.1016\/j.ctrv.2020.102016.
\n6. Tran TB, Maker VK, Maker AV. Impact of immunotherapy after resection of pancreatic cancer. J Am Coll Surg. 2019 Jul;229(1):19-27.e1. doi: 10.1016\/j.jamcollsurg.2019.01.016. Epub 2019 Feb 10.<\/p>\n","protected":false},"excerpt":{"rendered":"

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