查看“免疫荒漠型”的源代码

<div style="padding: 0 4%; line-height: 1.8; color: #1e293b; font-family: 'Helvetica Neue', Helvetica, 'PingFang SC', Arial, sans-serif; background-color: #ffffff; max-width: 1200px; margin: auto;">

    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">典型谱系：临床四大“免疫荒漠”</h2>
    
    <p style="margin: 15px 0; text-align: justify; color: #334155;">
        以下四种实体瘤在临床上表现出高度一致的<strong>[[原发性耐药]]</strong>特征。理解其各自独特的“荒漠化”机制，是制定联合治疗策略的前提。
    </p>

    <div style="overflow-x: auto; margin: 30px auto; max-width: 100%; border-radius: 8px; box-shadow: 0 4px 6px rgba(0,0,0,0.02);">
        <table style="width: 100%; border-collapse: collapse; border: 1px solid #cbd5e1; font-size: 0.9em; text-align: left;">
            <thead>
                <tr style="background-color: #0f172a; color: #ffffff;">
                    <th style="padding: 15px; border: 1px solid #0f172a; width: 20%;">肿瘤类型</th>
                    <th style="padding: 15px; border: 1px solid #0f172a; width: 45%;">“荒漠化”核心壁垒 (Mechanism)</th>
                    <th style="padding: 15px; border: 1px solid #0f172a; width: 35%;">临床现状与破局</th>
                </tr>
            </thead>
            <tbody>
                <tr style="border-bottom: 1px solid #e2e8f0;">
                    <td style="padding: 15px; background-color: #f8fafc; font-weight: bold; color: #0f172a; border-right: 2px solid #e2e8f0;">
                        [[胰腺导管腺癌]]<br><span style="font-weight: normal; color: #64748b;">(PDAC)</span>
                    </td>
                    <td style="padding: 15px; border-right: 1px solid #e2e8f0;">
                        <div style="margin-bottom: 8px;"><strong>1. 物理屏障 (基质):</strong> 极度致密的纤维化基质（Desmoplasia）如同“城墙”，物理阻隔 T 细胞浸润。</div>
                        <div><strong>2. 免疫抑制风暴:</strong> 微环境中充斥着 [[MDSC]]、Treg 和 M2 型巨噬细胞，效应 T 细胞极少。</div>
                    </td>
                    <td style="padding: 15px;">
                        <span style="background: #fee2e2; color: #b91c1c; padding: 2px 8px; border-radius: 4px; font-size: 0.85em; font-weight: bold;">特权之王</span><br>
                        <div style="margin-top: 6px; color: #334155;">单药有效率 ≈ 0%。<br><strong>策略：</strong>CD40 激动剂、基质耗竭剂、AG 化疗。</div>
                    </td>
                </tr>
                
                <tr style="border-bottom: 1px solid #e2e8f0; background-color: #fbfbfb;">
                    <td style="padding: 15px; background-color: #f1f5f9; font-weight: bold; color: #0f172a; border-right: 2px solid #e2e8f0;">
                        [[前列腺癌]]<br><span style="font-weight: normal; color: #64748b;">(Prostate Ca.)</span>
                    </td>
                    <td style="padding: 15px; border-right: 1px solid #e2e8f0;">
                        <div style="margin-bottom: 8px;"><strong>1. 缺乏靶标:</strong> 属于 TMB 最低的实体瘤之一，缺乏新抗原。</div>
                        <div><strong>2. PTEN 缺失:</strong> 导致 PI3K-AKT 通路激活，抑制细胞自噬，进一步下调抗原呈递。</div>
                    </td>
                    <td style="padding: 15px;">
                        <span style="background: #e0f2fe; color: #0369a1; padding: 2px 8px; border-radius: 4px; font-size: 0.85em; font-weight: bold;">极度冷漠</span><br>
                        <div style="margin-top: 6px; color: #334155;">除 MSI-H 外基本无效。<br><strong>策略：</strong>联合 PARP 抑制剂、PSMA 靶向疗法。</div>
                    </td>
                </tr>

                <tr style="border-bottom: 1px solid #e2e8f0;">
                    <td style="padding: 15px; background-color: #f8fafc; font-weight: bold; color: #0f172a; border-right: 2px solid #e2e8f0;">
                        [[MSS结直肠癌]]<br><span style="font-weight: normal; color: #64748b;">(MSS CRC)</span>
                    </td>
                    <td style="padding: 15px; border-right: 1px solid #e2e8f0;">
                        <div style="margin-bottom: 8px;"><strong>1. 机制性排斥:</strong> <strong>[[APC]]</strong> 突变激活 WNT/β-catenin 通路，直接抑制 DC 细胞的招募。</div>
                        <div><strong>2. 错配修复完整:</strong> pMMR 状态意味着突变极少，免疫系统“视而不见”。</div>
                    </td>
                    <td style="padding: 15px;">
                        <span style="background: #fef3c7; color: #92400e; padding: 2px 8px; border-radius: 4px; font-size: 0.85em; font-weight: bold;">95%的沉默</span><br>
                        <div style="margin-top: 6px; color: #334155;">由于 MSI-H 仅占 5%，绝大多数肠癌为冷肿瘤。<br><strong>策略：</strong>联合抗血管 (Regorafenib)。</div>
                    </td>
                </tr>

                <tr style="background-color: #fbfbfb;">
                    <td style="padding: 15px; background-color: #f1f5f9; font-weight: bold; color: #0f172a; border-right: 2px solid #e2e8f0;">
                        [[小细胞肺癌]]<br><span style="font-weight: normal; color: #64748b;">(SCLC)</span>
                    </td>
                    <td style="padding: 15px; border-right: 1px solid #e2e8f0;">
                        <div style="margin-bottom: 8px; color: #b91c1c;"><strong>⚠️ 高TMB的悖论:</strong> 虽因吸烟致高 TMB，但免疫原性极低。</div>
                        <div><strong>MHC-I 下调:</strong> 肿瘤细胞广泛下调 MHC-I 类分子，空有抗原却无法呈递 (Antigen Presentation Defect)。</div>
                    </td>
                    <td style="padding: 15px;">
                        <span style="background: #f3e8ff; color: #6b21a8; padding: 2px 8px; border-radius: 4px; font-size: 0.85em; font-weight: bold;">呈递缺陷</span><br>
                        <div style="margin-top: 6px; color: #334155;">长期获益人群少。<br><strong>策略：</strong>DLL3 双抗 (T-cell Engager) 替代 MHC 识别。</div>
                    </td>
                </tr>
            </tbody>
        </table>
    </div>
</div>