肿瘤相关成纤维细胞在胰腺癌治疗中的研究现状与应用前景  

Cancer-associated fibroblasts in pancreatic cancer therapy: current status and prospects

作　　者：刘嘉禹 杨尹默[1] 田孝东[1] Liu Jiayu;Yang Yinmo;Tian Xiaodong(Department of Hepatobiliary and Pancreatic Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院肝胆胰外科,北京100034

出　　处：《中华实验外科杂志》2025年第1期6-11,共6页Chinese Journal of Experimental Surgery

摘　　要：胰腺癌起病隐匿、进展快、手术切除率低、对现有治疗不敏感,预后极差。肿瘤相关成纤维细胞(CAFs)作为肿瘤微环境(TME)中的关键非肿瘤细胞成分,在胰腺癌的发生发展及治疗抵抗中扮演重要角色。本文综述了近年来针对胰腺癌CAFs的基础和临床研究进展,特别关注靶向肿瘤CAFs重塑TME治疗胰腺癌的研究现状及临床应用前景。胰腺癌CAFs异质性显著,不同亚型之间动态变化,对胰腺癌的免疫抑制状态和治疗抵抗有显著影响。靶向CAFs的治疗策略包括直接靶向CAFs、诱导CAFs再分化以及间接靶向CAFs,已成为胰腺癌治疗研究的新方向,有望提高胰腺癌治疗效果,也可增加对免疫治疗及放化疗的敏感性。然而,由于CAFs的高度异质性和可塑性,未来需要更精准的分子标志物和新型治疗手段,以实现对CAFs的精准重编程,改变胰腺癌TME及免疫抑制状态,为患者提供更精准、高效的综合治疗方案。Pancreatic cancer is characterized by its insidious onset,rapid progression,low surgical resection rate,and insensitivity to existing therapeutic drugs,leading to a very poor prognosis.Cancer-associated fibroblasts(CAFs),as key non-tumor cell components in the tumor microenvironment(TME),play a significant role in the occurrence,development,and therapeutic resistance of pancreatic cancer.This review summarizes recent basic and clinical research progress on pancreatic cancer CAFs,with a particular focus on the current status and clinical application prospects of targeting tumor CAFs to reshape the TME for the treatment of pancreatic cancer.The heterogeneity of CAFs in pancreatic cancer is significant,with dynamic shifts between different subtypes that markedly impact the immunosuppressive state and therapeutic resistance of pancreatic cancer.Therapeutic strategies targeting CAFs,including direct targeting of CAFs,CAFs redifferentiation,and indirect targeting of CAFs,have emerged as a new direction in pancreatic cancer research,holding promise to enhance the efficacy of pancreatic cancer treatments and increase sensitivity to immunotherapy and chemoradiotherapy.However,due to the high heterogeneity and plasticity of CAFs,more precise molecular markers and novel therapeutic approaches should be developed to achieve precise reprogramming of CAFs,alter the TME and immune suppression in pancreatic cancer,and provide patients with more accurate and efficient comprehensive treatment.

关 键 词：胰腺癌 肿瘤相关成纤维细胞 肿瘤微环境 免疫治疗 靶向治疗 

分 类 号：R735.9[医药卫生—肿瘤]