尿路上皮癌免疫治疗生物标志物的研究进展、挑战与多维度整合策略
Research Progress, Challenges and Multidimensional Integration Strategies of Immunotherapy Biomarkers in Urothelial Carcinoma
DOI: 10.12677/acm.2026.1652011, PDF,   
作者: 李嘉松：西安医学院研究生院，陕西 西安；范雪行, 李金城, 汪 涌*：空军军医大学第二附属医院泌尿外科，陕西 西安
关键词: 尿路上皮癌；免疫治疗；生物标志物；PD-L1；肿瘤突变负荷；多组学整合；Urothelial Carcinoma； Immunotherapy； Biomarkers； PD-L1； Tumor Mutational Burden； Multi-Omics Integration
摘要: 尿路上皮癌(UC)作为泌尿系统常见恶性肿瘤，免疫检查点抑制剂(ICIs)的临床应用显著改变了其治疗格局，但患者个体治疗反应差异巨大，精准预测疗效成为临床亟待解决的关键问题。生物标志物作为筛选获益人群、优化治疗策略的核心工具，近年来成为UC免疫治疗领域的研究热点。本文系统综述了经典生物标志物PD-L1、新兴标志物肿瘤突变负荷(TMB)及其他潜在标志物的研究现状，深入分析了当前生物标志物临床应用中存在的技术标准化不足、肿瘤异质性干扰、治疗背景影响等核心挑战，并探讨了多组学整合、联合治疗策略中的标志物应用等创新方向。最后，展望了未来通过技术标准化、机制深度解析及多维度评估体系构建，推动UC免疫治疗精准化发展的前景，为临床实践与科研探索提供参考。
Abstract: Urothelial carcinoma (UC) is a common malignant tumor of the urinary system. The clinical application of immune checkpoint inhibitors (ICIs) has significantly changed the therapeutic landscape. However, the therapeutic responses vary greatly among individual patients, and precise prediction of efficacy has become an urgent clinical issue. As a core tool for selecting beneficiary populations and optimizing treatment strategies, biomarkers have emerged as a research hotspot in the field of immunotherapy for UC in recent years. This paper systematically reviews the research progress of classic biomarkers such as PD-L1, emerging biomarkers including tumor mutational burden (TMB), and other potential biomarkers. It deeply analyzes the key challenges in the clinical application of current biomarkers, including insufficient technical standardization, interference of tumor heterogeneity, and the influence of therapeutic context. Furthermore, it discusses innovative directions such as multi-omics integration and biomarker application in combination therapy. Finally, it prospects the future of promoting the precise development of UC immunotherapy through technical standardization, in-depth mechanistic analysis, and the establishment of a multidimensional evaluation system, so as to provide references for clinical practice and scientific research.
文章引用：李嘉松, 范雪行, 李金城, 汪涌. 尿路上皮癌免疫治疗生物标志物的研究进展、挑战与多维度整合策略[J]. 临床医学进展, 2026, 16(5): 2053-2062. https://doi.org/10.12677/acm.2026.1652011

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