肾癌炎性微环境：机制解析与多模态影像评估
Inflammatory Microenvironment in Renal Cell Carcinoma: Mechanism Analysis and Multimodal Imaging Assessment
DOI: 10.12677/acm.2026.162497, PDF,   
作者: 李成林, 冉晨曦, 郑 婷：成都中医药大学医学与生命科学学院，四川 成都；邬颖华*：成都中医药大学附属医院放射科，四川 成都
关键词: 肾细胞癌；炎性微环境；多模态影像学；影像组学；Renal Cell Carcinoma； Inflammatory Microenvironment； Multimodal Imaging； Radiomics
摘要: 肾细胞癌的炎性微环境在肿瘤发生发展中起关键作用。本文系统综述了该环境中免疫细胞、间质细胞及脂肪组织通过细胞因子网络促进肿瘤进展的机制，并重点探讨了多模态影像学及影像组学在无创评估该环境中的应用价值。这些技术可对肾癌炎性微环境的特征进行无创化评估，为理解肿瘤生物学行为及制定个体化治疗策略提供了新视角。
Abstract: The inflammatory microenvironment plays a crucial role in the initiation and progression of renal cell carcinoma. This article systematically reviews the mechanisms by which immune cells, stromal cells, and adipose tissue within this microenvironment promote tumor progression through cytokine networks, with a particular focus on the application value of multimodal imaging and radiomics in the non-invasive assessment of this environment. These techniques enable the non-invasive characterization of features within the inflammatory microenvironment of renal cancer, offering novel perspectives for understanding tumor biology and guiding individualized therapeutic strategies.
文章引用：李成林, 冉晨曦, 郑婷, 邬颖华. 肾癌炎性微环境：机制解析与多模态影像评估[J]. 临床医学进展, 2026, 16(2): 1149-1154. https://doi.org/10.12677/acm.2026.162497

参考文献

[1] Cirillo, L., Innocenti, S. and Becherucci, F. (2024) Global Epidemiology of Kidney Cancer. Nephrology Dialysis Transplantation, 39, 920-928. [Google Scholar] [CrossRef] [PubMed]
[2] Xiao, Y. and Yu, D. (2021) Tumor Microenvironment as a Therapeutic Target in Cancer. Pharmacology & Therapeutics, 221, Article ID: 107753. [Google Scholar] [CrossRef] [PubMed]
[3] 张恒, 宋林涛, 曹德政, 等. 影像组学在放射治疗中的研究现状[J]. 临床放射学杂志, 2025, 44(4): 767-773.
[4] Balkwill, F. and Mantovani, A. (2001) Inflammation and Cancer: Back to Virchow? The Lancet, 357, 539-545. [Google Scholar] [CrossRef] [PubMed]
[5] Elinav, E., Nowarski, R., Thaiss, C.A., Hu, B., Jin, C. and Flavell, R.A. (2013) Inflammation-Induced Cancer: Crosstalk between Tumours, Immune Cells and Microorganisms. Nature Reviews Cancer, 13, 759-771. [Google Scholar] [CrossRef] [PubMed]
[6] Heintzman, D.R., Fisher, E.L. and Rathmell, J.C. (2022) Microenvironmental Influences on T Cell Immunity in Cancer and Inflammation. Cellular & Molecular Immunology, 19, 316-326. [Google Scholar] [CrossRef] [PubMed]
[7] Franklin, R.A., Liao, W., Sarkar, A., Kim, M.V., Bivona, M.R., Liu, K., et al. (2014) The Cellular and Molecular Origin of Tumor-Associated Macrophages. Science, 344, 921-925. [Google Scholar] [CrossRef] [PubMed]
[8] López, J.I., Errarte, P., Erramuzpe, A., Guarch, R., Cortés, J.M., Angulo, J.C., et al. (2016) Fibroblast Activation Protein Predicts Prognosis in Clear Cell Renal Cell Carcinoma. Human Pathology, 54, 100-105. [Google Scholar] [CrossRef] [PubMed]
[9] Errarte, P., Larrinaga, G. and López, J.I. (2020) The Role of Cancer-Associated Fibroblasts in Renal Cell Carcinoma. An Example of Tumor Modulation through Tumor/Non-Tumor Cell Interactions. Journal of Advanced Research, 21, 103-108. [Google Scholar] [CrossRef] [PubMed]
[10] Kumari, S., Advani, D., Sharma, S., Ambasta, R.K. and Kumar, P. (2021) Combinatorial Therapy in Tumor Microenvironment: Where Do We Stand? Biochimica et Biophysica Acta (BBA)—Reviews on Cancer, 1876, Article ID: 188585. [Google Scholar] [CrossRef] [PubMed]
[11] Sobiepanek, A., Kuryk, Ł., Garofalo, M., Kumar, S., Baran, J., Musolf, P., et al. (2022) The Multifaceted Roles of Mast Cells in Immune Homeostasis, Infections and Cancers. International Journal of Molecular Sciences, 23, Article 2249. [Google Scholar] [CrossRef] [PubMed]
[12] Papanikolaou, N., Matos, C. and Koh, D.M. (2020) How to Develop a Meaningful Radiomic Signature for Clinical Use in Oncologic Patients. Cancer Imaging, 20, Article No. 33. [Google Scholar] [CrossRef] [PubMed]
[13] 金嵚, 王洁琼, 邹俊婷, 等. 术前CT特征对肾透明细胞癌Fuhrman分级的预测价值[J]. 实用放射学杂志, 2023, 39(9): 1482-1486.
[14] Varghese, B., Cen, S., Zahoor, H., Siddiqui, I., Aron, M., Sali, A., et al. (2022) Feasibility of Using CT Radiomic Signatures for Predicting CD8-T Cell Infiltration and PD-L1 Expression in Renal Cell Carcinoma. European Journal of Radiology Open, 9, Article ID: 100440. [Google Scholar] [CrossRef] [PubMed]
[15] 王一凡, 陈自谦. 3.0TMRI扩散加权成像及灌注加权成像在肾脏良恶性肿瘤鉴别诊断中的效果评价[J]. 数理医药学杂志, 2020, 33(5): 676-677.
[16] Sun, R., Limkin, E.J., Vakalopoulou, M., Dercle, L., Champiat, S., Han, S.R., et al. (2018) A Radiomics Approach to Assess Tumour-Infiltrating CD8 Cells and Response to Anti-PD-1 or Anti-PD-L1 Immunotherapy: An Imaging Biomarker, Retrospective Multicohort Study. The Lancet Oncology, 19, 1180-1191. [Google Scholar] [CrossRef] [PubMed]
[17] Shieh, A., Cen, S.Y., Varghese, B.A., Hwang, D., Lei, X., Setayesh, A., et al. (2023) Radiomics Correlation to CD68+ Tumor-Associated Macrophages in Clear Cell Renal Cell Carcinoma. Oncology, 102, 260-270. [Google Scholar] [CrossRef] [PubMed]
[18] Li, R., Bing, X., Su, X., Zhang, C., Sun, H., Dai, Z., et al. (2024) The Potential Value of Dual-Energy CT Radiomics in Evaluating CD8+, CD163+ and αSMA+ Cells in the Tumor Microenvironment of Clear Cell Renal Cell Carcinoma. Clinical and Translational Oncology, 27, 716-726. [Google Scholar] [CrossRef] [PubMed]
[19] Guo, C., Liu, Y., Yang, H., Xia, Y., Li, X., Chen, L., et al. (2024) A Pilot Study of [68Ga]Ga-Fibroblast Activation Protein Inhibitor-04 PET/CT in Renal Cell Carcinoma. British Journal of Radiology, 97, 859-867. [Google Scholar] [CrossRef] [PubMed]
[20] Jiao, L., Wang, X., Ying, Y., et al. (2022) The Prognosis and Immune Microenvironment Related Factor Interleukin-23 in Clear Cell Renal Cell Carcinoma: A Radiological Investigation. Urology Journal, 19, 363-370.
[21] Wang, H., Song, X., Cheng, Y., Qu, Y., Zhang, S., Dai, B., et al. (2014) Visceral Fat Accumulation Is Associated with Different Pathological Subtypes of Renal Cell Carcinoma (RCC): A Multicentre Study in c Hina. BJU International, 114, 496-502. [Google Scholar] [CrossRef] [PubMed]
[22] 翁同辉, 任轲, 陈晗, 等. 内脏脂肪面积与肾癌病理分型及分级的相关性[J]. 现代泌尿外科杂志, 2021, 26(4): 322-327.
[23] Wang, H., Wu, J., Gu, W., Wang, B., Wan, F., Dai, B., et al. (2016) Serum Adiponectin Level May Be an Independent Predictor of Clear Cell Renal Cell Carcinoma. Journal of Cancer, 7, 1340-1346. [Google Scholar] [CrossRef] [PubMed]
[24] Pinthus, J.H., Kleinmann, N., Tisdale, B., Chatterjee, S., Lu, J., Gillis, A., et al. (2008) Lower Plasma Adiponectin Levels Are Associated with Larger Tumor Size and Metastasis in Clear-Cell Carcinoma of the Kidney. European Urology, 54, 866-874. [Google Scholar] [CrossRef] [PubMed]
[25] Lee, H.W., Jeong, B.C., Seo, S.I., Jeon, S.S., Lee, H.M., Choi, H.Y., et al. (2015) Prognostic Significance of Visceral Obesity in Patients with Advanced Renal Cell Carcinoma Undergoing Nephrectomy. International Journal of Urology, 22, 455-461. [Google Scholar] [CrossRef] [PubMed]
[26] Lennon, H., Sperrin, M., Badrick, E. and Renehan, A.G. (2016) The Obesity Paradox in Cancer: A Review. Current Oncology Reports, 18, Article No. 56. [Google Scholar] [CrossRef] [PubMed]
[27] Ladoire, S., Bonnetain, F., Gauthier, M., Zanetta, S., Petit, J.M., Guiu, S., et al. (2011) Visceral Fat Area as a New Independent Predictive Factor of Survival in Patients with Metastatic Renal Cell Carcinoma Treated with Antiangiogenic Agents. The Oncologist, 16, 71-81. [Google Scholar] [CrossRef] [PubMed]
[28] Cheng, X., Zhang, Y., Wang, C., Deng, W., Wang, L., Duanmu, Y., et al. (2018) The Optimal Anatomic Site for a Single Slice to Estimate the Total Volume of Visceral Adipose Tissue by Using the Quantitative Computed Tomography (QCT) in Chinese Population. European Journal of Clinical Nutrition, 72, 1567-1575. [Google Scholar] [CrossRef] [PubMed]
[29] Starekova, J., Zhao, R., Colgan, T.J., Johnson, K.M., Rehm, J.L., Wells, S.A., et al. (2022) Improved Free-Breathing Liver Fat and Iron Quantification Using a 2D Chemical Shift-Encoded MRI with Flip Angle Modulation and Motion-Corrected Averaging. European Radiology, 32, 5458-5467. [Google Scholar] [CrossRef] [PubMed]
[30] Lolli, C., Basso, U., Derosa, L., Scarpi, E., Sava, T., Santoni, M., et al. (2016) Systemic Immune-Inflammation Index Predicts the Clinical Outcome in Patients with Metastatic Renal Cell Cancer Treated with Sunitinib. Oncotarget, 7, 54564-54571. [Google Scholar] [CrossRef] [PubMed]
[31] Cordeiro, M.D., Ilario, E.N., Abe, D.K., Carvalho, P.A.D., Muniz, D.Q.B., Sarkis, A.S., et al. (2022) Neutrophil-to-Lymphocyte Ratio Predicts Cancer Outcome in Locally Advanced Clear Renal Cell Carcinoma. Clinical Genitourinary Cancer, 20, 102-106. [Google Scholar] [CrossRef] [PubMed]
[32] Wang, H., Gu, L., Jia, R., Zeng, J., Liu, X., Zhang, D., et al. (2017) Retrospective Evaluation of Ultrasound-Indeterminate Renal Multilocular Cystic Masses by Using Neutrophil-Lymphocyte Ratio and Computed Tomography. Urologic Oncology: Seminars and Original Investigations, 35, 35.e7-35.e14. [Google Scholar] [CrossRef] [PubMed]
[33] Zhang, H., Li, F., Jing, M., Xi, H., Zheng, Y. and Liu, J. (2024) Nomogram Combining Pre-Operative Clinical Characteristics and Spectral CT Parameters for Predicting the WHO/ISUP Pathological Grading in Clear Cell Renal Cell Carcinoma. Abdominal Radiology, 49, 1185-1193. [Google Scholar] [CrossRef] [PubMed]

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