胃型宫颈腺癌分子特征及免疫微环境调控与 治疗新策略
Molecular Characteristics, Immune Microenvironment Regulation, and Novel Therapeutic Strategies in Gastric-Type Endocervical Adenocarcinoma
摘要: 子宫颈胃型腺癌(gastric-type endocervical adenocarcinoma, G-EAC)是一种罕见但极具侵袭性的宫颈癌亚型，其发生与高危型人乳头瘤病毒(HPV)感染无关。其生物学行为、分子特征和治疗策略都与常见的HPV相关宫颈癌不同。G-EAC确诊时通常已属晚期，对传统放化疗不敏感，预后较差。本文主要对G-EAC独有的临床病理学及分子遗传学特点进行梳理，重点研究这些特点给靶向治疗和免疫治疗带来的新机遇。尽管PD-1、PD-L1抑制剂在部分G-EAC患者中有所显现，但是总体应答率不高。本文对目前的以免疫治疗为主的各种治疗方法进行了评价，并探讨了靶向肿瘤微环境以及其他的新的靶点等的价值，希望能给改善该难治性疾病的结果提供新的思路。
Abstract: Gastric-type endocervical adenocarcinoma (G-EAC) is a rare yet highly aggressive subtype of cervical cancer, whose development is independent of high-risk human papillomavirus (HPV) infection. Its biological behavior, molecular characteristics, and treatment strategies differ markedly from those of common HPV-associated cervical cancers. G-EAC is often diagnosed at an advanced stage, exhibits poor sensitivity to conventional radiotherapy and chemotherapy, and consequently carries a very poor prognosis. This article primarily aims to systematically delineate the unique clinicopathological and molecular genetic features of G-EAC, with a particular focus on investigating the novel opportunities these features present for targeted therapy and immunotherapy. Although PD-1/PD-L1 inhibitors have demonstrated some therapeutic activity in a subset of G-EAC patients, the overall response rate remains unsatisfactory. This paper provides a critical appraisal of various current treatment approaches, predominantly centered on immunotherapy, and explores the potential value of targeting the tumor microenvironment along with other emerging therapeutic targets. The overarching goal is to offer new perspectives and directions for improving outcomes in this refractory disease.
文章引用：陈锦华, 张硕, 汪宏波. 胃型宫颈腺癌分子特征及免疫微环境调控与 治疗新策略[J]. 临床医学进展, 2026, 16(3): 177-186. https://doi.org/10.12677/acm.2026.163777

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