PD-1/PD-L1抑制剂在胃癌的临床应用与耐药性挑战
Clinical Applications and Resistance Challenges of PD-1/PD-L1 Inhibitors in Gastric Cancer
DOI: 10.12677/acm.2025.1572035, PDF,   
作者: 杨葱葱：赣南医科大学第一临床医学院，江西 赣州；王建忠*：赣南医科大学第一附属医院普通外科，江西 赣州
关键词: 胃癌；PD-1；PD-L1；免疫检查点抑制剂；耐药机制；生物标志物；联合治疗；Gastric Cancer； PD-1； PD-L1； Immune Checkpoint Inhibitors； Resistance Mechanisms； Biomarkers； Combination Therapy
摘要: 胃癌的发病率在东亚地区呈现显著地域聚集性，是欧美国家的2~3倍。虽然根治性手术联合辅助化疗让早期患者的5年生存率提升至70%以上，但晚期的预后仍不容乐观。近年来，免疫检查点抑制剂的兴起，特别是针对PD-1及其配体PD-L1，通过阻断相关通路，成功唤醒T细胞的抗肿瘤免疫作用，逐步在临床中显现出治疗潜力。本文系统综述了PD-1/PD-L1抑制剂在胃癌中的表达特性、临床意义及其抑制剂的临床应用，并探讨了免疫治疗的耐药机制、潜在生物标志物以及联合治疗策略的最新进展，目的是为胃癌临床决策提供循证依据。
Abstract: The incidence of gastric cancer exhibits significant regional clustering in East Asia, where rates are 2 to 3 times higher than in Western countries. Although radical surgery combined with adjuvant chemotherapy has improved 5-year survival rates to over 70% in early-stage patients, outcomes for advanced-stage disease remain poor. In recent years, immune checkpoint inhibitors—particularly those targeting PD-1 and its ligand PD-L1—have demonstrated therapeutic promise by reactivating antitumor T-cell responses through pathway blockade. This review provides a comprehensive overview of PD-1/PD-L1 expression patterns in gastric cancer, their clinical significance, and the application of corresponding inhibitors. It also discusses mechanisms of resistance, emerging biomarkers, and advancements in combination therapy strategies, aiming to inform evidence-based clinical decision-making in the treatment of gastric cancer.
文章引用：杨葱葱, 王建忠. PD-1/PD-L1抑制剂在胃癌的临床应用与耐药性挑战[J]. 临床医学进展, 2025, 15(7): 641-653. https://doi.org/10.12677/acm.2025.1572035

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