219mze 发表于 2024-5-20 21:58:20

美国癌症病人宣布肿瘤全清除，癌症疫苗真的成功了吗？

<img src="https://mmbiz.qpic.cn/mmbiz_png/gKnytBjicgblFky0tYqRBw2TsDAuP81YC6IXdM6OmvMqJCXnm0aZOL1D7bABA6ur9xg7fTYtKlY4uVJmicG9n77g/640?wx_fmt=png&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/gKnytBjicgblFky0tYqRBw2TsDAuP81YC5nqeQMyKn3ngGbHms3t9C4ibdYj5maG0Ir2I3RDaD5WnkVToAy4TibhA/640?wx_fmt=png&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">
      <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">资讯</span>中<span style="color: black;">说到</span>的乳腺癌疫苗，还只<span style="color: black;">处在</span><span style="color: black;">初期</span>临床<span style="color: black;">实验</span><span style="color: black;">周期</span>，<span style="color: black;">日前</span><span style="color: black;">仅在</span>3个<span style="color: black;">病人</span>中试用，该名<span style="color: black;">病人</span>是其中一个，属于DCIS（乳腺癌0期<span style="color: black;">病人</span>），常规治疗效果就很好。</p>
    </span><span style="color: black;">类似的乳腺癌疫苗临床<span style="color: black;">实验</span>之前<span style="color: black;">亦</span>有<span style="color: black;">报告</span>，<span style="color: black;">病人</span>在接受疫苗后<span style="color: black;">亦</span><span style="color: black;">显现</span>“病理完全缓解”，但<span style="color: black;">日前</span>尚不<span style="color: black;">晓得</span>效果的持久性。&nbsp;</span><span style="color: black;">
      <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这些癌症疫苗都属于治疗型疫苗，与常说的预防性疫苗（HPV疫苗等）完全不<span style="color: black;">同样</span>。<span style="color: black;">倘若</span><span style="color: black;">资讯</span><span style="color: black;">报告</span>直接得出打疫苗能预防乳腺癌的结论，那是非常不专业的。</p>
    </span><img src="https://mmbiz.qpic.cn/mmbiz_png/gKnytBjicgblFky0tYqRBw2TsDAuP81YCAxwcXuFLHbWxCpqzeDwfXKh5WekYibvSLj4syGAoSK21K1ftVX8NDjA/640?wx_fmt=png&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><strong style="color: blue;">一节生姜</strong></strong></span></strong><span style="color: black;">宾夕法尼亚大学医学院</span><span style="color: black;">病理及实验医药系<span style="color: black;">科研</span>副教授</span><span style="color: black;"><span style="color: black;">近期</span>有一个<span style="color: black;">资讯</span><span style="color: black;">叫作</span>：</span><strong style="color: blue;"><span style="color: black;">美国新型抗癌疫苗<span style="color: black;">开发</span>成功！</span></strong><strong style="color: blue;"><span style="color: black;"><span style="color: black;">第1</span>例<span style="color: black;">病人</span>已宣布：</span></strong><strong style="color: blue;"><span style="color: black;">肿瘤<span style="color: black;">所有</span>清除！</span></strong><span style="color: black;">这是怎么回事呢？</span><strong style="color: blue;"><span style="color: black;">1、</span>该疫苗尚属<span style="color: black;">初期</span>临床<span style="color: black;">实验</span>，<span style="color: black;">重点</span>目的是测试安全性，<span style="color: black;">不可</span>等同于治疗的成功</strong><span style="color: black;">这个<span style="color: black;">资讯</span>的最早<span style="color: black;">源自</span>，应该是美国FOX电视台的<span style="color: black;">报告</span>。</span><img src="https://mmbiz.qpic.cn/mmbiz_png/gKnytBjicgbn6HqQxOtt42jwE9WHfJgI6KeTosKSGvcPreYKW0ic4efxRQuPmw5OE3yDA1oicwtcAF9yH1b3IMOgw/640?wx_fmt=png&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">FOX<span style="color: black;">资讯</span><span style="color: black;">报告</span>截图</span><span style="color: black;"><span style="color: black;">按照</span>这个<span style="color: black;">报告</span>，美国佛罗里达州一位健身达人丽·默克（Lee Mercker），<span style="color: black;">检测</span>出乳腺癌0期（DCIS），<span style="color: black;">而后</span>参加了梅奥诊所的乳腺癌疫苗的临床<span style="color: black;">实验</span>，接受了三次疫苗注射，之后进行了手术切除。<span style="color: black;">大夫</span>对手术切下的组织进行了<span style="color: black;">检测</span>，<span style="color: black;">发掘</span><span style="color: black;">已然</span><span style="color: black;">无</span>存活的肿瘤细胞。</span><span style="color: black;">该疫苗尚属<span style="color: black;">初期</span>临床<span style="color: black;">实验</span>，<span style="color: black;">日前</span>才在三个<span style="color: black;">病人</span>身上试用过。在<span style="color: black;">资讯</span>中，被采访的<span style="color: black;">大夫</span><span style="color: black;">说到</span>，<span style="color: black;">倘若</span>今后的临床<span style="color: black;">实验</span>顺利，该疫苗有望<span style="color: black;">能够</span>在8年之后<span style="color: black;">得到</span><span style="color: black;">准许</span>。</span><span style="color: black;">在转发<span style="color: black;">资讯</span>的时候，有的<span style="color: black;">报告</span>有意<span style="color: black;">没</span>意之中把可能性变<span style="color: black;">成为了</span>必然性：8年内上市。<span style="color: black;">乃至</span>还有的<span style="color: black;">报告</span>直接<span style="color: black;">运用</span>了<span style="color: black;">这般</span>的标题：</span><strong style="color: blue;"><span style="color: black;">美国新型抗癌疫苗<span style="color: black;">开发</span>成功！</span></strong><span style="color: black;">到底<span style="color: black;">可否</span>成功？<span style="color: black;">针对</span><span style="color: black;">初期</span>临床<span style="color: black;">实验</span>，目的<span style="color: black;">重点</span>是测试安全性，<span style="color: black;">倘若</span><span style="color: black;">病人</span><span style="color: black;">运用</span>之后<span style="color: black;">无</span><span style="color: black;">显现</span>安全问题，就<span style="color: black;">能够</span>说临床<span style="color: black;">实验</span>成功。<span style="color: black;">然则</span><span style="color: black;">初期</span>临床<span style="color: black;">实验</span>的成功，并不等同于治疗的成功，这就像一个<span style="color: black;">孩儿</span>小学四年级时成绩不错，<span style="color: black;">不可</span>就说他8年后就<span style="color: black;">能够</span>上北大清华。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/gKnytBjicgbn6HqQxOtt42jwE9WHfJgI67cic11vc8J8bN4tme6tP4FCatpmHSAMeCbRYIaV2x368vXO5iaYYjPuA/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><strong style="color: blue;"><span style="color: black;">2、</span>该名<span style="color: black;">病人</span>的癌症属于早<span style="color: black;">初期</span>，常规治疗效果就很不错</strong><span style="color: black;">参与临床<span style="color: black;">实验</span>的该名<span style="color: black;">病人</span>的癌症是DCIS，全名是<strong style="color: blue;">“乳腺导管原位癌”</strong>。癌症在<span style="color: black;">检测</span>出来的时候，<span style="color: black;">按照</span>病理<span style="color: black;">检测</span>结果<span style="color: black;">通常</span>分为1～4期。1～2期都算<span style="color: black;">初期</span>，4期被<span style="color: black;">叫作</span>为晚期。DCIS被定义<span style="color: black;">叫作</span>为0期， <span style="color: black;">亦</span><span style="color: black;">便是</span>早<span style="color: black;">初期</span>。<span style="color: black;">针对</span><span style="color: black;">这般</span>的癌症，常规治疗后的结果是<span style="color: black;">怎么样</span>的呢？</span><span style="color: black;">有一个对404名DCIS<span style="color: black;">病人</span>的10年随访<span style="color: black;">发掘</span>，<span style="color: black;">倘若</span>进行乳腺全切手术，<span style="color: black;">病人</span>10年内乳腺癌复发率为2.6%。<span style="color: black;">倘若</span>进行保乳手术及放疗，复发率为13.6%，但<span style="color: black;">倘若</span>只是进行保乳手术，<span style="color: black;">无</span>任何放化疗，复发率为25.5%</span><span style="color: black;"></span><span style="color: black;">。</span><span style="color: black;"><span style="color: black;">因此</span>，<span style="color: black;">倘若</span>是像对待<span style="color: black;">初期</span>乳腺<span style="color: black;">病人</span><span style="color: black;">同样</span>，<span style="color: black;">即时</span>进行保乳手术，其他什么治疗都不做，在10年内75%的<span style="color: black;">病人</span>连复发都不会<span style="color: black;">显现</span>。</span><span style="color: black;">不仅如此，进一<span style="color: black;">步骤</span>查<span style="color: black;">发掘</span>，<span style="color: black;">倘若</span>仅仅只是进行活检，活检之后什么治疗都不做，10年内复发率<span style="color: black;">亦</span><span style="color: black;">仅有</span>27.8%。这个比例只比保乳手术差了两个百分点。</span><span style="color: black;"><span style="color: black;">不外</span>，<span style="color: black;">由于</span><span style="color: black;">日前</span>的<span style="color: black;">检测</span>技术<span style="color: black;">没</span>法对DCIS<span style="color: black;">病人</span>做出清楚的预后，没法<span style="color: black;">晓得</span>她是属于不会复发的那72.2%，还是属于会复发的27.8%，为了<span style="color: black;">尽可能</span>避免坏的结果，<span style="color: black;">大夫</span>都会<span style="color: black;">意见</span>DCIS的<span style="color: black;">病人</span>采取治疗<span style="color: black;">办法</span>。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/gKnytBjicgbn6HqQxOtt42jwE9WHfJgI6RG6l8c5ISSnxysHiaWuq7dwibKhlM1x5kibyeXY944t73pD3ps4dzrIOw/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><strong style="color: blue;"><span style="color: black;">3、</span><span style="color: black;">日前</span>乳腺癌疫苗的<span style="color: black;">科研</span>有<span style="color: black;">非常多</span>，但<span style="color: black;">最后</span>效果还很难说</strong><span style="color: black;"><span style="color: black;">资讯</span>里关于佛罗里达该名<span style="color: black;">病人</span>的<span style="color: black;">报告</span>，其实只是<span style="color: black;">科研</span>中的一个<span style="color: black;">发展</span>，结果虽然是个很好的<span style="color: black;">信息</span>，<span style="color: black;">亦</span>给<span style="color: black;">非常多</span><span style="color: black;">病人</span>带来鼓舞，<span style="color: black;">然则</span>远远<span style="color: black;">无</span>到“<span style="color: black;">开发</span>成功”的<span style="color: black;">周期</span>。</span><span style="color: black;">这<span style="color: black;">亦</span><strong style="color: blue;">完全不是乳腺癌疫苗<span style="color: black;">第1</span>次大显身手</strong>。</span><span style="color: black;">其实<span style="color: black;">日前</span>有<span style="color: black;">非常多</span>乳腺癌疫苗的临床<span style="color: black;">科研</span>都在进行，<span style="color: black;">况且</span>不少癌症疫苗都是像梅奥诊所的这个<span style="color: black;">科研</span><span style="color: black;">同样</span>，<span style="color: black;">运用</span>树突细胞（DC）来更有效地呈递癌抗原，以<span style="color: black;">得到</span>更好的效果。</span><span style="color: black;"><span style="color: black;">例如</span>在宾夕法尼亚大学进行的一项乳腺癌疫苗的临床<span style="color: black;">实验</span>，<span style="color: black;">实验</span>结果<span style="color: black;">已然</span>在2017年<span style="color: black;">发布</span>。在这个<span style="color: black;">实验</span>中，<strong style="color: blue;"><span style="color: black;">显现</span>肿瘤消失的<span style="color: black;">病人</span>不是一两例，而是12例。</strong></span><span style="color: black;">当然，总共接受疫苗的DCIS<span style="color: black;">病人</span>有42名，<span style="color: black;">因此</span><span style="color: black;">得到</span>病理完全缓解（pCR）的比例，是28.6%。</span><span style="color: black;">乳腺癌疫苗哪家强？是梅奥诊所？还是宾大？很难说。</span><span style="color: black;">梅奥诊所这个疫苗，<span style="color: black;">日前</span><span style="color: black;">仅有</span>三个<span style="color: black;">病人</span>，一个<span style="color: black;">显现</span>肿瘤完全消失，pCR为33%；<span style="color: black;">倘若</span>之后接着治疗两个病例，假设再<span style="color: black;">显现</span>一个完全缓解，pCR<span style="color: black;">便是</span>40%；<span style="color: black;">倘若</span>都<span style="color: black;">无</span><span style="color: black;">显现</span>完全缓解，pCR就降为20%。<span style="color: black;">因此</span>，样本太少，未知数太多。</span><span style="color: black;">从<span style="color: black;">日前</span>的数据来看，宾大的结果更可信，<span style="color: black;">由于</span>毕竟治疗了42个<span style="color: black;">病人</span>，<span style="color: black;">况且</span>结果是正式<span style="color: black;">发布</span>在学术期刊上，不是在<span style="color: black;">资讯</span>、电视上抢眼球。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/gKnytBjicgbn6HqQxOtt42jwE9WHfJgI6mKleGfq7F7fn46Y4cMNXHWibSHfpq5ibOpSLPK7qOaRxZ91aPtb5mqhw/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><strong style="color: blue;"><span style="color: black;">4、</span><span style="color: black;">媒介</span>对待医学<span style="color: black;">科研</span><span style="color: black;">发展</span>应该科学<span style="color: black;">报告</span>，避免误导公众</strong><span style="color: black;">严格<span style="color: black;">来讲</span>，宾大和梅奥诊所的乳腺癌疫苗，都属于<strong style="color: blue;">治疗型疫苗</strong>，<span style="color: black;">亦</span><span style="color: black;">便是</span>在<span style="color: black;">已然</span><span style="color: black;">检测</span>出癌症之后<span style="color: black;">运用</span>。这与常说的预防性的疫苗完全不<span style="color: black;">同样</span>。</span><span style="color: black;"><span style="color: black;">因此</span>，<span style="color: black;">倘若</span><span style="color: black;">资讯</span><span style="color: black;">报告</span><span style="color: black;">按照</span><span style="color: black;">日前</span>的结果，就得出靠几针疫苗能预防乳腺癌的结论，那说明是非常不专业的<span style="color: black;">报告</span>。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/gKnytBjicgbn6HqQxOtt42jwE9WHfJgI6Uib7QycdEp096ZxiaibNSwCWVaW3QNibgnxw58Gs2VBZMic3Ddlk7ZzYoGw/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">如今癌症<span style="color: black;">病人</span>越来越多，公众对癌症<span style="color: black;">科研</span>的关注<span style="color: black;">亦</span>越来越多，这其实是好事。癌症<span style="color: black;">科研</span><span style="color: black;">每日</span>都有<span style="color: black;">发展</span>，<span style="color: black;">重要</span>是<span style="color: black;">怎么样</span>正确地把这些<span style="color: black;">发展</span>介绍给<span style="color: black;">大众</span>。</span><span style="color: black;"><span style="color: black;">倘若</span>是夸大效果的<span style="color: black;">报告</span>，公众确实<span style="color: black;">能够</span>感到欢欣鼓舞，<span style="color: black;">然则</span>却可能误导<span style="color: black;">病人</span>，<span style="color: black;">引起</span><span style="color: black;">劫难</span>性的结果。</span><span style="color: black;"><span style="color: black;">例如</span>在梅奥诊所治疗的丽·默克，<span style="color: black;">实质</span>上在接受疫苗之后，还进行了手术切除。而在宾大的临床<span style="color: black;">实验</span>中，<span style="color: black;">倘若</span><span style="color: black;">病人</span>不是DCIS，而是<span style="color: black;">初期</span>的乳腺癌，那完全缓解率<span style="color: black;">仅有</span>8%。</span><span style="color: black;"><span style="color: black;">因此</span>，这种疫苗的效果，即便由临床<span style="color: black;">实验</span>完全坐实，<span style="color: black;">亦</span>只是锦上添花。<span style="color: black;">倘若</span><span style="color: black;">不可</span>正确理解，<span style="color: black;">针对</span>一个非早<span style="color: black;">初期</span>的<span style="color: black;">病人</span><span style="color: black;">来讲</span>，<span style="color: black;">倘若</span>放弃正规的治疗，梦想靠着这个疫苗来达到某种神奇效果，就会误入歧途。</span><span style="color: black;"><span style="color: black;">因此</span>，<span style="color: black;">咱们</span><span style="color: black;">能够</span>为<span style="color: black;">将来</span>的新治疗欢欣鼓舞，<span style="color: black;">然则</span><span style="color: black;">针对</span><span style="color: black;">日前</span>的治疗，<span style="color: black;">必定</span>要<span style="color: black;">安身</span>于<span style="color: black;">已然</span>被临床<span style="color: black;">实验</span>所证实并正式<span style="color: black;">得到</span><span style="color: black;">准许</span>治疗。</span><span style="color: black;">参考文献：</span><span style="color: black;">Stuart KE, Houssami N, Taylor R, Hayen ABoyages J (2015) Long-term outcomes of ductal carcinoma in situ of the breast: a systematic review, meta-analysis and meta-regression analysis. BMC Cancer 15:890.</span><span style="color: black;">Lowenfeld L, Mick R, Datta J, Xu S, Fitzpatrick E, et al. (2017) Dendritic Cell Vaccination Enhances Immune Responses and Induces Regression of HER2(pos) DCIS Independent of Route: Results of Randomized Selection Design Trial. Clin Cancer Res 23:2961-2971.</span><strong style="color: blue;">本文编辑：yhxi</strong><strong style="color: blue;">©版权声明：</strong><strong style="color: blue;">本文系腾讯较真平台独家稿件，未经授权，禁止<span style="color: black;">媒介</span>转载。</strong><strong style="color: blue;">欢迎个人转发至<span style="color: black;">伴侣</span>圈。</strong><img src="https://mmbiz.qpic.cn/mmbiz_jpg/gKnytBjicgblhYr69xu6ZiaPibCypInroHPWoLnGQwgR8MohDuNBQYibKck9icGs7Dx9QHdDLI1hReaLx1IYBKkTsIA/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><a style="color: black;"><strong style="color: blue;">艾灸<span style="color: black;">能够</span>治疗癌症？</strong></a><a style="color: black;"><strong style="color: blue;">流感疫苗能够预防感冒？</strong></a><strong style="color: blue;"><a style="color: black;">HPV疫苗是“绝育疫苗”？</a></strong><a style="color: black;"><strong style="color: blue;">老</strong></a><strong style="color: blue;">年<span style="color: black;">痴傻</span>疫苗研制成功，即将<span style="color: black;">面世</span>？</strong><a style="color: black;"><strong style="color: blue;">美国癌症疫苗<span style="color: black;">开发</span>成功，彻底根治率达 97%？</strong></a><img src="https://mmbiz.qpic.cn/mmbiz_jpg/gKnytBjicgbn6x4Yyz0wD893gJjttrPNLQMs3PicJYnrfmJ3nDvgWpQTR5Ro45kBCdtxJIQ2yXluJeF5XIICfj2A/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/gKnytBjicgbn6x4Yyz0wD893gJjttrPNLBcibjpFxJxoicVa6LSAlh2ribOYQjraIG7s0pB1xNcad0Ve5YLQtQyuog/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">一惊一乍的人儿，咱能歇歇了不？</span><img src="https://mmbiz.qpic.cn/mmbiz_gif/gKnytBjicgbn6x4Yyz0wD893gJjttrPNLDF1KA2nxJmL4yGANxyaPkxgnicalu3l4CGeibAN73ib7DVDMu4hsNZ3Yw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><strong style="color: blue;"><span style="color: black;">有问题问较真妹&nbsp;<strong style="color: blue;"><span style="color: black;"><a style="color: black;">点我提问</a></span></strong></span></strong><span style="color: black;"><strong style="color: blue;"><span style="color: black;">扫码关注我，健康走近你</span></strong></span><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/gKnytBjicgbmh1jAcU2oMSl6NHTiaGeCiakjlzeheMCwX2p87oS37a2DYXuqZZAdnS4cL9L1bdicdKbABhQacGyhBQ/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></span></strong></span><img src="https://mmbiz.qpic.cn/mmbiz_png/gKnytBjicgbmh1jAcU2oMSl6NHTiaGeCiake3rRgDbwJQftaCyvZILO82bGlxic0aHsXyEUiawsQqlnRp0ZaT8x7psw/640?wx_fmt=png&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><strong style="color: blue;">点一下“<strong style="color: blue;">在看</strong>”，传递健康知识</strong></span><img src="https://mmbiz.qpic.cn/mmbiz_gif/gKnytBjicgbmh1jAcU2oMSl6NHTiaGeCiak13kNGfEo3CJsaTukUy7BVSQFiaB3W9Y2DhX7d7ZY98tdD7d7sU6U5wg/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;">



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