曹 阳,张翠英

据世界卫生组织统计，非小细胞肺癌（NSCLC）发病率逐年攀升，仍是影响人类生存的主要因素之一。免疫治疗是继手术、放化疗和靶向等传统治疗方法之后的新型抗肿瘤手段，其机制是激活免疫系统，以促进宿主免疫细胞对肿瘤细胞的杀伤作用。以抗细胞毒性T淋巴细胞相关蛋白4（CTLA-4）单抗和抗程序性细胞死亡受体-1（PD-1）单抗/配体1（PD-L1）单抗等免疫检查点抑制剂（ICIs）为代表的免疫治疗贯穿在NSCLC治疗的各个阶段，使某些晚期NSCLC患者的5年生存率由5%提高到16%。遗憾的是，仅20％的NSCLC患者可在免疫治疗中获益，因此，迫切需要能够筛选对免疫治疗更加获益的人群的标志物。近年来，随着基因组学和代谢组学技术的成熟，人们逐渐发现对免疫治疗敏感的患者的肠道菌群和代谢物组成有一定特征，这些具有特征性的肠道菌群和代谢物可以作为标志物来预测免疫治疗的预后，也可以被开发为“免疫增效剂”来辅助免疫治疗。但是，目前这些特征性的菌群和代谢物尚有争论且俩者影响免疫疗效的机制仍不明确。因此，在这篇综述中，我们将重点关注与晚期NSCLC免疫疗效相关的肠道菌群和代谢物以及它们影响免疫疗效的潜在分子机制，为增强免疫疗效提供新思路。

中国晚期非小细胞肺癌；免疫治疗；肠道菌群；肠道代谢物；肿瘤微环境；宿主免疫系统

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