编辑丨王多鱼 排版丨水成文 在 肿瘤免疫治疗 领域，除了 T 细胞主导的细胞免疫，由 B 细胞和抗体介导的体液免疫也日益受到重视。 三级淋巴结 构 （ TLS ） 作为肿瘤微环境中的 " 临时淋巴结 " ，是 B 细胞活化与抗体产生的关键场所 。然而，在 局部进展期直 肠癌 （ LARC ） 中，成熟 TLS （ mTLS ） 的功能定位及其在新辅助治疗 （ neoTx ） 干预下的动态变化，仍是领域 内关注的重点。 在临床预后方面，研究证实 mTLS 的存在以及浆细胞标志物 CD138 的高表达，均与患者更长的总生存期 （ OS ） 显 著相关。在公共数据库 （ TCGA-READ ） 中的验证也表明，高表达 TLS 形成关键因子 CXCL13 或浆细胞基因签名 的患者，其预后同样更好。这提示了 mTLS 及其支持的 B 细胞免疫是直肠癌的有利预后标志。 2025 年 11 月 18 日，解放军总医院 普通外科医学部 杜峻峰 课题组与北京协和医院 吴斌 团队合作 （ 田娜 、 王乾 宇 、 吕远 为论文第一作者 ） ，在《柳叶刀》 （The Lancet） 子刊 eBiomedicine 上发表了题为： M ...

Core Viewpoint - Immune checkpoint blockade therapy has significantly changed the landscape of cancer treatment, showing strong efficacy in various cancer types, but the reasons for differential responses among patients remain unclear [1][3]. Group 1: Research Findings - A recent study published in Nature reveals that autoantibodies (AAb), typically associated with autoimmune diseases, can influence the response of cancer patients to immune checkpoint blockade therapy [3][5]. - The research involved 374 cancer patients receiving immune checkpoint blockade therapy and 131 healthy controls, mapping the immune response to 6172 extracellular and secreted proteins [5]. - The study identified approximately 3000 unique autoantibody responses in cancer patients, indicating a diverse "autoantibody response group" that has not yet reached saturation [7]. Group 2: Clinical Implications - Patients with interferon-targeting antibodies have a 40-fold higher probability of responding to treatment, contrasting with COVID-19, where similar antibodies increase mortality risk by 20-200 times [7]. - The findings suggest that targeting the exoproteome with specific autoantibodies could enhance the efficacy of immune checkpoint blockade therapy, leading to the potential development of drugs that mimic beneficial autoantibodies or neutralize harmful ones [9]. - The study also highlights that anti-TL1A antibodies enhance treatment effects by preventing T-cell apoptosis in the tumor microenvironment [12]. Group 3: Future Directions - The research opens new avenues for optimizing cancer immunotherapy by leveraging the role of autoantibodies in treatment responses, providing new targets and strategies for improving patient outcomes [9].