乳腺癌早期筛查、精准诊断、有效治疗是提高患者生存率的重要因素，而影像学是筛查、诊断、治疗评估的主要手段。基于现有的影像技术，乳腺临床诊治流程虽然已逐步规范化，但在高效灵敏筛查、无创精准诊断以及治疗监测评估等方面仍存在核心局限。例如，传统的医学影像技术存在诊断特异性低、成像速度慢、使用电离辐射或注射造影剂等局限，仍存在重大临床诉求。光声成像作为一项新兴的医学影像技术，可以与传统技术形成优势互补，提供快速（如10~15 s完成全乳腺扫描）、高分辨率、信息丰富的医学影像。其光学对比度和声学分辨率使之具备揭示肿瘤微环境结构、功能、分子细节特征的能力。本文简述了光声成像的技术原理和主要设计形态，概述并评价了乳腺肿瘤筛查、诊断和治疗评估领域的代表性光声成像研究。最后讨论了光声成像在乳腺临床上的应用前景，其有望成为继钼靶、超声、核磁共振之后的“第四大”乳腺成像技术。

肿瘤微环境呈现出一个错综复杂的生态系统, 包括肿瘤细胞、非癌细胞、细胞外基质以及微生物群落等多种要素。微生物在肿瘤内广泛分布, 其在空间分布上呈现出显著的特异性。这些微生物的组成成分与功能状态在肿瘤的发生和进展中发挥着至关重要的作用。本文深入阐明了肿瘤微环境内微生物菌群的特征, 并探索其对肿瘤发生发展的影响机制, 以期为肿瘤的诊断和治疗提供全新的策略和视角。

The tumor microenvironment (TME) is now recognized as an important participant of tumor progression. As the most abundant extracellular matrix component in TME, collagen plays an important role in tumor development. The imaging study of collagen morphological feature in TME is of great significance for understanding the state of tumor. Multiphoton microscopy (MPM), based on second harmonic generation (SHG) and two-photon excitation fluorescence (TPEF), can be used to monitor the morphological changes of biological tissues without labeling. In this study, we used MPM for large-scale imaging of early invasive breast cancer from the tumor center to normal tissues far from the tumor. We found that there were significant differences in collagen morphology between breast cancer tumor boundary, near tumor transition region and normal tissues far from the tumor. Furthermore, the morphological feature of eight collagen fibers was extracted to quantify the variation trend of collagen in three regions. These results may provide a new perspective for the optimal negative margin width of breast-conserving surgery and the understanding of tumor metastasis.

建立了小鼠原位肝癌模型，利用活体荧光成像系统激发的荧光信号对肿瘤进行了定位，通过光声显微成像系统观察了正常肝小叶、肿瘤中心和癌旁的微血管结构特征和血氧功能。结果表明，正常的血管分布均匀、分化良好，而肿瘤的血管分布不均匀且混乱，分支直径增加，更适合低氧环境。光声技术在研究肝细胞癌方面展现出巨大的潜力，可以为肿瘤抗血管生成治疗和诸多肝脏相关疾病的诊断提供更深入的见解。

The tumor microenvironment (TME) promotes pro-tumor and anti-inflammatory metabolisms and suppresses the host immune system. It prevents immune cells from fighting against cancer effectively, resulting in limited efficacy of many current cancer treatment modalities. Different therapies aim to overcome the immunosuppressive TME by combining various approaches to synergize their effects for enhanced anti-tumor activity and augmented stimulation of the immune system. Immunotherapy has become a major therapeutic strategy because it unleashes the power of the immune system by activating, enhancing, and directing immune responses to prevent, control, and eliminate cancer. Phototherapy uses light irradiation to induce tumor cell death through photothermal, photochemical, and photo-immunological interactions. Phototherapy induces tumor immunogenic cell death, which is a precursor and enhancer for anti-tumor immunity. However, phototherapy alone has limited effects on long-term and systemic anti-tumor immune responses. Phototherapy can be combined with immunotherapy to improve the tumoricidal effect by killing target tumor cells, enhancing immune cell infiltration in tumors, and rewiring pathways in the TME from anti-inflammatory to pro-inflammatory. Phototherapy-enhanced immunotherapy triggers effective cooperation between innate and adaptive immunities, specifically targeting the tumor cells, whether they are localized or distant.Herein, the successes and limitations of phototherapy combined with other cancer treatment modalities will be discussed. Specifically, we will review the synergistic effects of phototherapy combined with different cancer therapies on tumor elimination and remodeling of the immunosuppressive TME. Overall, phototherapy, in combination with other therapeutic modalities, can establish anti-tumor pro-inflammatory phenotypes in activated tumor-infiltrating T cells and B cells and activate systemic anti-tumor immune responses.

谷胱甘肽（GSH）在多种肿瘤细胞中过表达，是肿瘤微环境的重要特征之一，以GSH作为触发因子可以实现肿瘤的精准治疗。GSH是一种内源性抗氧化剂，其分子结构中的巯基官能团能够快速消耗肿瘤细胞内的活性氧物种（ROS），降低光动力治疗（PDT）的效果；相反，GSH的消耗也可以增强PDT。因此，以GSH作为生物靶标及触发因子设计GSH响应型光敏剂有望实现高效精准的肿瘤PDT。本文首先对GSH在生物体内的作用进行了简单介绍，进而对GSH激活型和GSH消耗型光敏剂的响应机制与响应型PDT进行了详细阐述，最后对GSH响应型光敏剂在肿瘤光动力治疗中面临的挑战以及未来的发展方向进行了讨论。

为观察肝癌细胞(HepG2)条件培养基对人脐静脉血管内皮细胞(HUVEC)形貌和超微结构的影响, 建立HepG2细胞条件培养基(HepG2-CM)与HUVEC细胞共培养体系。通过倒置显微镜观察HUVEC细胞形态的变化, 通过扫描电镜(SEM)检测HUVEC细胞超微结构的变化, 通过原子力显微镜(AFM)分析细胞膜表面粗糙度的变化。对照组细胞之间紧密依靠, 细胞膜边缘平整, 细胞黏附排列致密; HepG2-CM组细胞之间连接疏散, 细胞膜边缘模糊, 细胞黏附减弱, 两组细胞膜表面高低差(Rp-v)为(454.83±29.99)nm和(501.28±11.78)nm, P=0.028; 均方根粗糙度(Rq)为(32.84±4.70)nm和(45.03±3.84)nm, P=0.007; 平均粗糙度(Ra)为(25.06±4.09)nm和(34.39±3.58)nm, P=0.014; 平均高度(Meant Ht)为(204.03±11.65)nm和(301.48±12.80)nm, P=0; 中位数高度(Median Ht)为(206.55±7.46)nm和(313.25±5.89)nm, P=0。结果表明, HepG2-CM能诱导HUVEC细胞黏附减弱, 细胞之间连接疏散, “伪足”样突起形成, 细胞膜表面粗糙度增加。该研究有助于我们进一步理解肿瘤微环境中血管内皮细胞生物学行为, 为抗肿瘤血管生成的研究提供思路。

碳点作为一种新型碳纳米材料，具有优异的光学特性、良好的生物相容性以及催化活性，在生物医学、能源、环境等领域展现出巨大的应用潜力。红光/近红外光响应碳点具有组织穿透深度大、生物体自发光干扰较小、对组织损伤小等优点，在生物医学研究领域倍受关注。本文首先介绍了影响碳点吸收/发光的因素，随后评述了近几年红光/近红外光响应碳点在肿瘤治疗中的新进展，主要包括光动力治疗、光热治疗、光动力/光热协同治疗等。同时，针对肿瘤微环境的特点，介绍了微环境响应型碳点及其在肿瘤治疗中的应用研究进展。最后，对碳点在肿瘤治疗领域存在的挑战进行了展望。