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肿瘤免疫微环境 - 版本历史
2026-04-19T20:58:43Z
本wiki的该页面的版本历史
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2026年1月2日 (五) 22:59 77921020
2026-01-02T22:59:06Z
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">←上一版本</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">2026年1月2日 (五) 22:59的版本</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l91" >第91行：</td>
<td colspan="2" class="diff-lineno">第91行：</td></tr>
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<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <div style="overflow-x: auto; margin: 30px auto; max-width: <del class="diffchange diffchange-inline">90</del>%;"></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <div style="overflow-x: auto; margin: 30px auto; max-width: <ins class="diffchange diffchange-inline">100</ins>%;"></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <table style="width: 100%; border-collapse: collapse; border: 1.2px solid #cbd5e1; font-size: 0.95em; text-align: left;"></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <table style="width: 100%; border-collapse: collapse; border: 1.2px solid #cbd5e1; font-size: 0.95em; text-align: left;"></div></td></tr>
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77921020
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2026年1月2日 (五) 22:55 77921020
2026-01-02T22:55:56Z
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<a href="https://www.yiliao.com/index.php?title=%E8%82%BF%E7%98%A4%E5%85%8D%E7%96%AB%E5%BE%AE%E7%8E%AF%E5%A2%83&diff=312385&oldid=312384">显示更改</a>
77921020
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2026年1月2日 (五) 22:51 77921020
2026-01-02T22:51:26Z
<p></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">←上一版本</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">2026年1月2日 (五) 22:51的版本</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l17" >第17行：</td>
<td colspan="2" class="diff-lineno">第17行：</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="padding: 25px; text-align: center; background-color: #f8fafc;"></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="padding: 25px; text-align: center; background-color: #f8fafc;"></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="display: inline-block; background: #ffffff; border: 1px solid #e2e8f0; border-radius: 12px; padding: 20px; box-shadow: 0 4px 10px rgba(0,0,0,0.04);"></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="display: inline-block; background: #ffffff; border: 1px solid #e2e8f0; border-radius: 12px; padding: 20px; box-shadow: 0 4px 10px rgba(0,0,0,0.04);"></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <ins class="diffchange diffchange-inline">[[Image:Tumor_Microenvironment_Composition.png|100px|复杂的细胞生态系统]]</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </div></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </div></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="font-size: 0.8em; color: #64748b; margin-top: 12px; font-weight: 600;">复杂的细胞生态系统</div></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="font-size: 0.8em; color: #64748b; margin-top: 12px; font-weight: 600;">复杂的细胞生态系统</div></div></td></tr>
<tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l90" >第90行：</td>
<td colspan="2" class="diff-lineno">第90行：</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </p></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </p></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </div></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </div></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"> </del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="overflow-x: auto; margin: 30px auto; max-width: 90%;"></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="overflow-x: auto; margin: 30px auto; max-width: 90%;"></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <table style="width: 100%; border-collapse: collapse; border: 1.2px solid #cbd5e1; font-size: 0.95em; text-align: left;"></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <table style="width: 100%; border-collapse: collapse; border: 1.2px solid #cbd5e1; font-size: 0.95em; text-align: left;"></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr style="background-color: #f8fafc; border-bottom: 2px solid #0f172a;"></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr style="background-color: #f8fafc; border-bottom: 2px solid #0f172a;"></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #0f172a; width: 22%;"><del class="diffchange diffchange-inline">表型 (Phenotype)</del></th></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #0f172a<ins class="diffchange diffchange-inline">; width: 18%;">表型</th></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #1e40af</ins>; width: 22%;"><ins class="diffchange diffchange-inline">典型代表癌种</ins></th></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">免疫状态特征</th></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">免疫状态特征</th></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">主要障碍</th></del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #1e40af;"><ins class="diffchange diffchange-inline">治疗策略</ins></th></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <th style="padding: 12px; border: 1px solid #cbd5e1; color: #1e40af;"><del class="diffchange diffchange-inline">治疗策略建议</del></th></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #15803d;">[[免疫炎症型]]<br>(<del class="diffchange diffchange-inline">Inflamed / </del>Hot)</td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #15803d;">[[免疫炎症型]]<br>(Hot)</td></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><del class="diffchange diffchange-inline">大量 TILs 浸润实质，IFN</del>-<del class="diffchange diffchange-inline">γ 通路激活，</del>[[<del class="diffchange diffchange-inline">PD-L1</del>]] <del class="diffchange diffchange-inline">高表达。</del></td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1<ins class="diffchange diffchange-inline">; color: #334155</ins>;"></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><del class="diffchange diffchange-inline"><strong></del>[[<del class="diffchange diffchange-inline">T细胞耗竭</del>]]<del class="diffchange diffchange-inline"></strong> (Exhaustion)</del></td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[黑色素瘤]]<br></ins></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;">单药 [[PD-1抑制剂]] <del class="diffchange diffchange-inline">即可见效。</del></td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[非小细胞肺癌]] (高TMB)<br></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[MSI</ins>-<ins class="diffchange diffchange-inline">H结直肠癌]]<br></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • </ins>[[<ins class="diffchange diffchange-inline">肾透明细胞癌</ins>]]</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> </ins></td></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><ins class="diffchange diffchange-inline">TILs 浸润实质，[[PD-L1]] 高表达，T细胞呈现“</ins>[[<ins class="diffchange diffchange-inline">耗竭</ins>]]<ins class="diffchange diffchange-inline">”状态。</ins></td></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;">单药 [[PD-1抑制剂]] <ins class="diffchange diffchange-inline">疗效佳。</ins></td></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #1e40af;">[[免疫排斥型]]<br>(Excluded)</td></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #1e40af;">[[免疫排斥型]]<br>(Excluded)</td></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><del class="diffchange diffchange-inline">T 细胞停留在侵袭边缘或间质，无法进入癌巢。</del></td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1<ins class="diffchange diffchange-inline">; color: #334155</ins>;"></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><strong><del class="diffchange diffchange-inline">物理屏障</del></strong> <del class="diffchange diffchange-inline">(基质</del>/<del class="diffchange diffchange-inline">血管) & TGF-β</del></td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[微卫星稳定结直肠癌]] (MSS)<br></ins></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;">联合抗 [[VEGF]] 或 [[TGF-β]] <del class="diffchange diffchange-inline">药物 </del>+ ICIs。</td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[肝细胞癌]] (HCC)<br></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[卵巢癌]]<br></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • 部分[[胰腺癌]]</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> </ins></td></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><ins class="diffchange diffchange-inline">T 细胞被</ins><strong><ins class="diffchange diffchange-inline">[[基质]]</ins></strong><ins class="diffchange diffchange-inline">或异常<strong>[[血管]]<</ins>/<ins class="diffchange diffchange-inline">strong>阻挡在侵袭边缘，无法进入。</ins></td></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;">联合抗 [[VEGF]] 或 [[TGF-β]] + ICIs。</td></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <tr></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #b91c1c;">[[免疫荒漠型]]<br>(Desert <del class="diffchange diffchange-inline">/ Cold</del>)</td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #b91c1c;">[[免疫荒漠型]]<br>(Desert)</td></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><del class="diffchange diffchange-inline">缺乏 T 细胞浸润，通常 </del>[[<del class="diffchange diffchange-inline">TMB</del>]] <del class="diffchange diffchange-inline">低，无抗原呈递。</del></td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1<ins class="diffchange diffchange-inline">; color: #334155</ins>;"></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><del class="diffchange diffchange-inline"><strong>免疫忽视</strong> </del>(Ignorance) <del class="diffchange diffchange-inline">/ 启动失败</del></td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[前列腺癌]]<br></ins></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;">需 [[癌症疫苗]]、[[<del class="diffchange diffchange-inline">溶瘤病毒</del>]] 或 [[<del class="diffchange diffchange-inline">CAR-T</del>]] 引燃。</td></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[胶质母细胞瘤]]<br></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • [[小细胞肺癌]] (SCLC)<br></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> • </ins>[[<ins class="diffchange diffchange-inline">HR+乳腺癌</ins>]]</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"> </ins></td></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;"><ins class="diffchange diffchange-inline">缺乏 T 细胞浸润，TMB 低，免疫忽视 </ins>(Ignorance)<ins class="diffchange diffchange-inline">。</ins></td></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <td style="padding: 10px; border: 1px solid #cbd5e1;">需 [[癌症疫苗]]、[[<ins class="diffchange diffchange-inline">CAR-T</ins>]] 或 [[<ins class="diffchange diffchange-inline">BiTE</ins>]] 引燃。</td></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </tr></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </table></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </table></div></td></tr>
<tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l130" >第130行：</td>
<td colspan="2" class="diff-lineno">第144行：</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <li style="margin-bottom: 12px;"><strong>3. 逃逸 (Escape)：</strong> 肿瘤通过下调 [[MHC-I]]、表达 [[PD-L1]]、招募 [[Tregs]] 等机制，彻底逃脱免疫监视，形成临床可见的肿瘤。</li></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <li style="margin-bottom: 12px;"><strong>3. 逃逸 (Escape)：</strong> 肿瘤通过下调 [[MHC-I]]、表达 [[PD-L1]]、招募 [[Tregs]] 等机制，彻底逃脱免疫监视，形成临床可见的肿瘤。</li></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </ul></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </ul></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> <ins class="diffchange diffchange-inline">[[Image:Cancer_Immunoediting_3E.png|100px|3E假说图解]]</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="font-size: 0.92em; line-height: 1.6; color: #1e293b; margin-top: 50px; border-top: 2px solid #0f172a; padding: 15px 25px; background-color: #f8fafc; border-radius: 0 0 10px 10px;"></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> <div style="font-size: 0.92em; line-height: 1.6; color: #1e293b; margin-top: 50px; border-top: 2px solid #0f172a; padding: 15px 25px; background-color: #f8fafc; border-radius: 0 0 10px 10px;"></div></td></tr>
</table>
77921020
https://www.yiliao.com/index.php?title=%E8%82%BF%E7%98%A4%E5%85%8D%E7%96%AB%E5%BE%AE%E7%8E%AF%E5%A2%83&diff=312383&oldid=prev
77921020：建立内容为“<div style="padding: 0 4%; line-height: 1.8; color: #1e293b; font-family: 'Helvetica Neue', Helvetica, 'PingFang SC', Arial, sans-serif; background-color: #ffffff…”的新页面
2026-01-02T22:48:02Z
<p>建立内容为“<div style="padding: 0 4%; line-height: 1.8; color: #1e293b; font-family: 'Helvetica Neue', Helvetica, 'PingFang SC', Arial, sans-serif; background-color: #ffffff…”的新页面</p>
<p><b>新页面</b></p><div><div style="padding: 0 4%; line-height: 1.8; color: #1e293b; font-family: 'Helvetica Neue', Helvetica, 'PingFang SC', Arial, sans-serif; background-color: #ffffff; max-width: 1200px; margin: auto;"><br />
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<strong>肿瘤免疫微环境</strong>（Tumor Immune Microenvironment, <strong>TIME</strong>）是指肿瘤细胞生存的复杂生态系统，不仅包含恶性增殖的肿瘤细胞，还包括浸润的<strong>[[免疫细胞]]</strong>、<strong>[[肿瘤相关成纤维细胞]]</strong> (CAFs)、<strong>[[内皮细胞]]</strong>以及它们分泌的细胞因子和<strong>[[细胞外基质]]</strong> (ECM)。TIME 不是静止的旁观者，而是与肿瘤细胞发生持续的“共进化” (Co-evolution)。根据<strong>[[CD8+ T细胞]]</strong>的浸润程度和空间分布，TIME 被临床划分为三种主要亚型：<strong>[[免疫炎症型]]</strong> (Hot)、<strong>[[免疫排斥型]]</strong> (Excluded) 和<strong>[[免疫荒漠型]]</strong> (Desert)。这一分类系统目前是预测 <strong>[[ICIs]]</strong> (免疫检查点抑制剂) 疗效和制定联合治疗策略的核心依据。<br />
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<div style="font-size: 1.2em; font-weight: bold; letter-spacing: 1.2px;">肿瘤免疫微环境</div><br />
<div style="font-size: 0.7em; opacity: 0.85; margin-top: 4px; white-space: nowrap;">Acronym: TIME (点击展开)</div><br />
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<div style="font-size: 0.8em; color: #64748b; margin-top: 12px; font-weight: 600;">复杂的细胞生态系统</div><br />
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<th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0; width: 40%;">核心组成</th><br />
<td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">免疫细胞, 基质细胞, 细胞因子</td><br />
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<th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">主要抗肿瘤细胞</th><br />
<td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #15803d;">[[CD8+ T细胞]], [[NK细胞]], [[M1型巨噬细胞]]</td><br />
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<th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">主要促肿瘤细胞</th><br />
<td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #b91c1c;">[[Tregs]], [[MDSCs]], [[M2型巨噬细胞]]</td><br />
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<th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">关键检查点</th><br />
<td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">[[PD-1]] / [[PD-L1]], [[CTLA-4]]</td><br />
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<th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">代谢特征</th><br />
<td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">[[缺氧]], 酸性, 葡萄糖匮乏</td><br />
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<th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">临床评估</th><br />
<td style="padding: 10px 12px; border-bottom: 1px solid #e2e8f0; color: #1e40af;">[[免疫评分]] (Immunoscore)</td><br />
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<th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569;">经典分型</th><br />
<td style="padding: 6px 12px; color: #0f172a;">Inflamed / Excluded / Desert</td><br />
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<h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">TIME 的细胞图谱：善恶对决</h2><br />
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肿瘤微环境是一个高度动态的战场，其中不同类型的细胞扮演着截然相反的角色，决定了肿瘤是发展还是被清除。<br />
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<h4 style="margin: 0 0 10px 0; color: #15803d; border-bottom: 1px solid #bbf7d0; padding-bottom: 8px;">🛡️ 抗肿瘤免疫 (Effector)</h4><br />
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<li style="margin-bottom: 8px;"><strong>[[CD8+ T细胞]]：</strong> 杀伤肿瘤的主力军，识别 MHC-I 呈递的抗原。</li><br />
<li style="margin-bottom: 8px;"><strong>[[NK细胞]]：</strong> 自然杀伤细胞，识别 MHC 缺失的肿瘤细胞。</li><br />
<li style="margin-bottom: 8px;"><strong>[[DC细胞]] (cDC1)：</strong> 关键的抗原呈递者，负责激活 T 细胞 (Priming)。</li><br />
<li><strong>[[M1型巨噬细胞]]：</strong> 分泌促炎因子，直接吞噬或辅助杀伤。</li><br />
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<h4 style="margin: 0 0 10px 0; color: #b91c1c; border-bottom: 1px solid #fecaca; padding-bottom: 8px;">🦠 促肿瘤免疫 (Suppressor)</h4><br />
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<li style="margin-bottom: 8px;"><strong>[[Tregs]]：</strong> 调节性 T 细胞，通过分泌 [[IL-10]]/[[TGF-β]] 抑制效应 T 细胞。</li><br />
<li style="margin-bottom: 8px;"><strong>[[MDSCs]]：</strong> 髓源性抑制细胞，消耗精氨酸，抑制 T 细胞增殖。</li><br />
<li style="margin-bottom: 8px;"><strong>[[M2型巨噬细胞]] (TAMs)：</strong> 促进血管生成 ([[VEGF]]) 和基质重塑。</li><br />
<li><strong>[[CAFs]]：</strong> 肿瘤相关成纤维细胞，构建物理屏障。</li><br />
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<h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">免疫表型分类 (Chen & Mellman Classification)</h2><br />
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<h3 style="margin-top: 0; color: #1e40af; font-size: 1.1em;">TIME 的空间异质性</h3><br />
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2017年，Daniel Chen 和 Ira Mellman 提出的三分法是目前最通用的分类标准，直接指导临床用药策略。<br />
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<th style="padding: 12px; border: 1px solid #cbd5e1; color: #0f172a; width: 22%;">表型 (Phenotype)</th><br />
<th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">免疫状态特征</th><br />
<th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">主要障碍</th><br />
<th style="padding: 12px; border: 1px solid #cbd5e1; color: #1e40af;">治疗策略建议</th><br />
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<td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #15803d;">[[免疫炎症型]]<br>(Inflamed / Hot)</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;">大量 TILs 浸润实质，IFN-γ 通路激活，[[PD-L1]] 高表达。</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;"><strong>[[T细胞耗竭]]</strong> (Exhaustion)</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;">单药 [[PD-1抑制剂]] 即可见效。</td><br />
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<td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #1e40af;">[[免疫排斥型]]<br>(Excluded)</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;">T 细胞停留在侵袭边缘或间质，无法进入癌巢。</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;"><strong>物理屏障</strong> (基质/血管) & TGF-β</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;">联合抗 [[VEGF]] 或 [[TGF-β]] 药物 + ICIs。</td><br />
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<td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600; color: #b91c1c;">[[免疫荒漠型]]<br>(Desert / Cold)</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;">缺乏 T 细胞浸润，通常 [[TMB]] 低，无抗原呈递。</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;"><strong>免疫忽视</strong> (Ignorance) / 启动失败</td><br />
<td style="padding: 10px; border: 1px solid #cbd5e1;">需 [[癌症疫苗]]、[[溶瘤病毒]] 或 [[CAR-T]] 引燃。</td><br />
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<h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">动态演变：肿瘤免疫编辑 (Immunoediting)</h2><br />
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TIME 不是一成不变的。根据 Schreiber 提出的 3E 假说，肿瘤与免疫系统的相互作用经历三个阶段：<br />
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<li style="margin-bottom: 12px;"><strong>1. 清除 (Elimination)：</strong> 免疫系统成功识别并消灭早期癌变细胞，维持机体健康。</li><br />
<li style="margin-bottom: 12px;"><strong>2. 平衡 (Equilibrium)：</strong> 免疫系统无法完全清除肿瘤，但能抑制其生长。肿瘤细胞在压力下发生突变，低免疫原性的克隆被筛选出来。</li><br />
<li style="margin-bottom: 12px;"><strong>3. 逃逸 (Escape)：</strong> 肿瘤通过下调 [[MHC-I]]、表达 [[PD-L1]]、招募 [[Tregs]] 等机制，彻底逃脱免疫监视，形成临床可见的肿瘤。</li><br />
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<span style="color: #0f172a; font-weight: bold; font-size: 1.05em; display: inline-block; margin-bottom: 15px;">学术参考文献与权威点评</span><br />
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[1] <strong>Chen DS, Mellman I. (2017).</strong> <em>Elements of cancer immunity and the limits of immunotherapy.</em> <strong>[[Nature]]</strong>. 2017;541(7637):321-330.<br><br />
<span style="color: #475569;">[学术点评]：奠基之作。该综述系统提出了肿瘤免疫表型的三分法 (Inflamed/Excluded/Desert)，不仅解释了 PD-1/PD-L1 抗体的疗效差异，更为下一代免疫治疗的联合策略指明了方向。</span><br />
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[2] <strong>Hanahan D, Weinberg RA. (2011).</strong> <em>Hallmarks of cancer: the next generation.</em> <strong>[[Cell]]</strong>. 2011;144(5):646-674.<br><br />
<span style="color: #475569;">[学术点评]：经典理论。在原有的癌症六大特征基础上，增加了“避免免疫破坏” (Avoiding Immune Destruction) 和“促肿瘤炎症” (Tumor-promoting Inflammation)，正式确立了 TIME 在肿瘤生物学中的核心地位。</span><br />
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[3] <strong>Galon J, et al. (2006).</strong> <em>Type, density, and location of immune cells within human colorectal tumors predict clinical outcome.</em> <strong>[[Science]]</strong>. 2006;313(5795):1960-1964.<br><br />
<span style="color: #475569;">[学术点评]：临床转化。该研究首次证明了肿瘤内部免疫细胞的浸润程度（即后来的 [[免疫评分]] Immunoscore）比传统的 TNM 分期能更准确地预测结直肠癌患者的生存期。</span><br />
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[4] <strong>Schreiber RD, Old LJ, Smyth MJ. (2011).</strong> <em>Cancer immunoediting: integrating immunity's roles in cancer suppression and promotion.</em> <strong>[[Science]]</strong>. 2011;331(6024):1565-1570.<br><br />
<span style="color: #475569;">[学术点评]：机制理论。提出了著名的“3E 假说” (Elimination, Equilibrium, Escape)，完美解释了免疫系统如何从“抗癌卫士”转变为“肿瘤帮凶”的动态过程。</span><br />
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肿瘤免疫微环境 (TIME) · 知识图谱<br />
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<td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">子级分型</td><br />
<td style="padding: 10px 15px; color: #334155;">[[免疫炎症型]] (Hot) • [[免疫排斥型]] (Excluded) • [[免疫荒漠型]] (Desert)</td><br />
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<td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">关键细胞</td><br />
<td style="padding: 10px 15px; color: #334155;">[[CD8+ T细胞]] • [[Tregs]] • [[MDSCs]] • [[TAMs]] • [[CAFs]]</td><br />
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<td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">评估工具</td><br />
<td style="padding: 10px 15px; color: #334155;">[[免疫评分]] (Immunoscore) • [[TMB]] • [[空间转录组学]]</td><br />
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<td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">核心理论</td><br />
<td style="padding: 10px 15px; color: #334155;">[[免疫编辑]] (3E假说) • [[癌症十大特征]] • [[共进化]]</td><br />
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