摘要：热肿瘤 VS 冷肿瘤：肿瘤类型之间的差异-科普翻译-（2022-12-6）
正文：
热肿瘤 VS 冷肿瘤：肿瘤类型之间的差异
【1】According to modern scientific concepts, tumor types are now categorized into separate groups based on their response rate to immune checkpoint inhibitors (ICI). In practical terms, which can be understood more clearly in the medical field, tumor types are categorized as either 'hot' or 'cold'.
根据现代科学概念，现在根据对免疫检查点抑制剂（ICI）的反应率将肿瘤类型分为不同的组。实际上，在医学领域可以更清楚地理解，肿瘤类型分为“热”或“冷”。
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【2】
什么是热肿瘤？
Hot tumors have a high mutation load and respond faster to ICIs. They accumulate a lot of mutations, which causes tumor cells to produce specific molecules, neoantigens, on their cell surface. These neoantigens make the tumor more vulnerable to recognition by the immune system and thus more likely to elicit a strong immune response.
热肿瘤具有高突变负荷并且对 ICI 反应更快。它们积累了大量的突变，导致肿瘤细胞在其细胞表面产生特定的分子，即新抗原。这些新抗原使肿瘤更容易被免疫系统识别，因此更有可能引发强烈的免疫反应。
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【3】Malignant tumors considered 'hot' include cancer of the bladder, head and neck, kidney cancer, liver cancer, melanoma, and non-small cell lung cancer, as well as tumors of various types with a high rate of microsatellite instability. It is in these types of tumors that inhibitors of immune checkpoints are effective.
被认为是“热”的恶性肿瘤包括膀胱癌、头颈癌、肾癌、肝癌、黑色素瘤和非小细胞肺癌，以及微卫星不稳定率高的各种类型的肿瘤。正是在这些类型的肿瘤中，免疫检查点抑制剂才有效。
【4】
什么是冷肿瘤？
Cold tumors have a low response rate and are often referred to as an impregnable fortress surrounded by a moat. There are few T-cells in their 'walls', and it is extremely difficult for them to mobilize an immune response. Common cancers that have 'cold' tumors include glioblastoma, ovarian, prostate, and pancreatic cancer.
冷肿瘤反应率低，常被称为被护城河包围的坚不可摧的堡垒。它们的“墙内”几乎没有 T 细胞，它们极难调动免疫反应。具有“冷”肿瘤的常见癌症包括胶质母细胞瘤、卵巢癌、前列腺癌和胰腺癌。
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moat 可以联想 boat
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【5】
区分这两种类型的重要性
The categorical range from hot to cold tumors is described in different ways. Why is it important? For two reasons: the first is that the 'temperature coloration' of the tumor is associated with other key features of the mutation load, i.e., the number of mutations for a certain part of the genome.
从热肿瘤到冷肿瘤的分类范围以不同的方式描述。它为什么如此重要？有两个原因：首先是肿瘤的“温度着色”与突变负荷的其他关键特征相关，即基因组特定部分的突变数量。
【6】The highest mutation load and the highest number of mutations per genome region are observed in hot tumors.
在热肿瘤中观察到最高的突变负荷和每个基因组区域的最高突变数量。
Image Credit: Anusorn Nakdee/Shutterstock.com
【7】The mutation load differs in tumors of 'immune exclusion' and is sharply reduced in cold tumors. In addition, tumour proliferative activity is also temperature-dependent.
突变负荷在“免疫排斥”肿瘤中不同，在冷肿瘤中急剧减少。此外，肿瘤增殖活性也具有温度依赖性。
【8】If we take specific tumors and distribute them on the temperature map, we will see that the most characteristic among the hot tumors is melanoma. It has a high mutation load and proliferates much faster than other tumours in the cold spectrum.
如果我们把具体的肿瘤拿来在温度图上进行分布，就会发现热肿瘤中最具特征的是黑色素瘤。它具有高突变负荷，并且比冷谱中的其他肿瘤增殖快得多。
【9】
Application for medical practice
行医申请
For oncologists, the main issue remains the possibility of using this concept in therapeutic approaches. Dividing tumors based on different temperatures determines the therapeutic approach needed to treat them. This is now being used more and more in practice.
对于肿瘤学家来说，主要问题仍然是在治疗方法中使用这一概念的可能性。根据不同的温度划分肿瘤决定了治疗它们所需的治疗方法。现在在实践中使用得越来越多。
【11】Studies found that immune checkpoint inhibitors act better for tumors of the 'hot' type. This is natural since the point of application of these drugs is the immune cells that are present in the tumor. These drugs work much worse in 'cold' tumors, where there are few such cells or none.
研究发现，免疫检查点抑制剂对“热”型肿瘤的作用更好。这是自然的，因为这些药物的作用点是存在于肿瘤中的免疫细胞。这些药物在“冷”肿瘤中效果更差，因为这种细胞很少或根本没有。
【12】
考虑到年龄
A good example of 'immune exclusion' is colorectal cancer in adulthood, which is rarely seen in children. Childhood tumors tend to be on the blue part of the spectrum (cold tumors), while in adulthood, tumors are more apparent within the red part of the spectrum (hot tumors).
“免疫排斥”的一个很好的例子是成年期的结直肠癌，这在儿童中很少见。儿童肿瘤往往位于光谱的蓝色部分（冷肿瘤），而在成年期，肿瘤在光谱的红色部分（热肿瘤）中更为明显。
【13】Among adult patients, prostate carcinoma is very common, being the most common tumor in men in the US. Angiogenesis and its interaction with the tumor stroma play an important role in tumorigenesis and tumor formation. Active angiogenesis, the presence of reactive stroma, as well as suppressive cells are characteristic of 'immune exclusion' tumors.
在成年患者中，前列腺癌非常常见，是美国男性中最常见的肿瘤。血管生成及其与肿瘤间质的相互作用在肿瘤发生和肿瘤形成中起重要作用。活跃的血管生成、反应性基质的存在以及抑制性细胞是“免疫排斥”肿瘤的特征。
【14】
点燃冰冷的心
One interesting method to 'ignite the cold heart' of a non-immunoreactive tumor is using oncolytic viruses. What processes make this possible? During transformation, tumour cells acquire defects in numerous signalling pathways that simultaneously affect cell growth control and innate antiviral defence systems.
“点燃非免疫反应性肿瘤的冷心”的一种有趣方法是使用溶瘤病毒。什么过程使这成为可能？在转化过程中，肿瘤细胞在许多信号通路中出现缺陷，这些信号通路同时影响细胞生长控制和先天抗病毒防御系统。
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【15】As a result, such tumors become susceptible to several naturally occurring or genetically modified viruses that selectively replicate inside tumor cells and kill them without damaging healthy tissues.
结果，这些肿瘤变得容易受到几种天然存在或转基因病毒的影响，这些病毒可以选择性地在肿瘤细胞内复制并杀死它们而不损害健康组织。
【16】The fundamental characteristics of an ideal oncolytic virus are specificity, safety, and efficacy. Specificity means affinity for malignant tissues with minimal toxic effects on non-tumor cells. Host safety means that the virus cannot spread in a population of healthy cells and be transmitted from person to person.
理想的溶瘤病毒的基本特征是特异性、安全性和有效性。特异性是指对恶性组织的亲和力，对非肿瘤细胞的毒性作用最小。宿主安全意味着病毒不能在健康细胞群中传播，也不能在人与人之间传播。
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