实用老年医学

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免疫衰老在老年非小细胞肺癌中的作用机制研究进展


  

  1. 南京医科大学附属苏州医院胸外科

Advances in the mechanisms of immunosenescence in elderly patients with non-small cell lung cancer

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  1. Department of Thoracic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215000, China

摘要: 免疫衰老是伴随机体衰老发生的免疫功能退化现象,以胸腺萎缩、T细胞多样性降低及慢性炎症为标志。在老年非小细胞肺癌(NSCLC)中,免疫衰老通过重塑肿瘤微环境、促进免疫抑制细胞增殖和削弱效应T细胞抗肿瘤能力,加速疾病进展。从分子层面来看,端粒缩短、表观遗传变化与代谢异常驱动这一过程,并影响免疫检查点抑制剂的治疗效果。本文综述了免疫衰老的生物学特性及其在老年NSCLC疾病进展中的作用机制,揭示其对肿瘤免疫的深远影响,为优化治疗策略提供理论支持。

关键词: 免疫衰老, 非小细胞肺癌, 老年人, 肿瘤微环境, 免疫疗法

Abstract: Immunosenescence refers to the progressive decline in immune function associated with aging, characterized by thymic involution, reduced T-cell diversity, and chronic inflammation. In elderly patients with non-small cell lung cancer (NSCLC), immunosenescence accelerates disease progression by remodeling the tumor microenvironment, promoting the proliferation of immunosuppressive cells, and impairing the antitumor activity of effector T cells. At the molecular level, telomere shortening, epigenetic alterations, and metabolic dysregulation drive this process, influencing the therapeutic efficacy of immune checkpoint inhibitors. This review synthesizes the biological features of immunosenescence and its mechanistic roles in the progression of NSCLC in the elderly, highlights its profound impact on tumor immunity and provides a theoretical foundation for optimizing treatment strategies.

Key words: immunosenescence, non-small cell lung cancer, aged, tumor microenvironment, immunotherapy

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