胰腺癌病理学和肿瘤微环境研究进展  

Advances in pathology and tumor microenvironment of pancreatic cancer

作　　者：王栋 沈军[1] WANG Dong;SHEN Jun(General Surgery Department of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medical,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院普通外科,上海200092

出　　处：《临床普外科电子杂志》2022年第3期19-25,87,共8页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：胰腺癌是一种死亡率极高的恶性肿瘤,早期诊断率偏低。对于流行病学及危险因素的研究,可能会有助于制订有效的筛查措施。胰腺癌的准确分期对于制订规范化综合治疗方案和判断预后都有重要意义。有研究鉴别出32个在正常胰腺组织向癌组织转化过程中反复突变的基因,并汇入10条信号通路,包括KRAS、TGF-β、WNT、NOTCH、ROBO/SLIT、G_(1)/S转换、SWI-SNF、染色质修饰、DNA修复和RNA加工。胰腺癌中的恶性肿瘤细胞占比有限,其余的是细胞外基质、胰腺星状细胞、成纤维细胞、内皮细胞和免疫细胞等组成的间质成分。化疗、靶向治疗和免疫治疗的效果有限,一定程度上都归因于胰腺癌微环境的作用。本文拟对胰腺癌病理学和微环境中的各种组分,以及其如何形成一个免疫抑制、低氧和纤维组织增生的肿瘤微环境进行综述。Pancreatic cancer is a kind of malignant tumor with high mortality and low early diagnosis rate,therefore,studies of epidemiology and risk factors of pancreatic cancer may help develop effective screening measures so as to reduce mortality.Accurate staging of pancreatic cancer is of great significance for the formulation of standardized comprehensive treatment and prognosis.32 recurrently mutated genes in pancreatic carcinogenesis are identified,and aggregate into 10 pathways,include KRAS,TGF-β,WNT,NOTCH,ROBO/SLIT signaling,G_(1)/S transition,SWI-SNF,chromatin modification,DNA repair and RNA processing.Malignant cells often represent the minority of tissue mass in a pancreatic tumor,with the remainder of the tumor composed of extracellular matrix,pancreatic stellate cells,fibroblasts,endothelial cells and immune cells,etc.To some extent,therapeutic failures of chemotherapy,targeted therapy,and immunotherapy have been attributed to the pancreatic cancer microenvironment.This review summarizes the pathology,microenvironment of pancreatic cancer,and explains how each cell type contributes to form an immunosuppressive,hypoxic,and desmoplastic tumor microenvironment.

关 键 词：胰腺癌 病理学 肿瘤 微环境 

分 类 号：R73[医药卫生—肿瘤]