لخّصلي

Elimination The elimination phase of the cancer immunoediting process is essentially the same as the immunosurveillance concept that we previously discussed.17-10), some of the tumor cells may develop into genetic variants that are resistant to immune defenses, similar to the development of antibiotic resistance by bacteria.If the immunologic mechanisms involved in immunosurveillance, such as destruction of cancerous cells by the host's NK cells and cytotoxic T cells, are highly effective, they will likely result in complete elimination of the tumor.The dynamic interactions between the tumor and the immune system are thought to shape the phenotype of the tumor and its ultimate outcome, hence the term immunoediting.During the equilibrium phase, mutations can occur in the genetically unstable transformed cells.

Elimination
The elimination phase of the cancer immunoediting process is essentially the same as the
immunosurveillance concept that we previously discussed. If the immunologic mechanisms
involved in immunosurveillance, such as destruction of cancerous cells by the host’s NK cells
and cytotoxic T cells, are highly effective, they will likely result in complete elimination of the
tumor. If the immune responses are not completely effective, some of the tumor cells will
remain in the body. These cells are then thought to enter the equilibrium phase.
Equilibrium
In this phase, tumor cells are thought to enter a state of dynamic equilibrium with the immune
system, which keeps the altered cells under control so that they are not clinically evident.
During this period, tumor cells may remain dormant or evolve slowly over time. The dynamic
interactions between the tumor and the immune system are thought to shape the phenotype of
the tumor and its ultimate outcome, hence the term immunoediting. Therefore, the tumor may
eventually be eliminated by the body, establish permanent residence in the equilibrium phase, or
evolve into a phenotype that can escape the immune system and cause disease.
During the equilibrium phase, mutations can occur in the genetically unstable transformed
cells. Under selective pressure from immunologic forces of attack by cells in the tumor
microenvironment (Fig. 17–10), some of the tumor cells may develop into genetic variants that
are resistant to immune defenses, similar to the development of antibiotic resistance by bacteria.
These cells move past the equilibrium phase and enter the escape phase.