胰腺癌神经侵犯机制及应对策略的研究进展

Advancement in researches of mechanism of nervous invasion of pancreatic cancer and its countermeasures

胰腺癌的神经侵犯（PNI）是胰腺癌的独立预后指标及术后复发转移的重要相关因素，但目前为止，其机制仍未完全明了。本文综述了近来在神经侵犯机制中相关因素的最新进展，包括诸如神经分布，临床病理因素，淋巴管及血管，细胞因子，黏附分子，一些免疫球蛋白超家族成员以及黏蛋白在神经侵犯发生、发展中的作用。此外，也对胰腺癌诊治手段的进步进行了概述总结。

Perineural invasion（PNI） is regarded as a factor associated with local recurrence and an important prognostic factor in pancreatic cancer. Little is known about the mechanism of PNI in Pancreatic cancer. This review summarizes the role of innervation, clinicopathologic factors, iymhatic vessels, vascularity, cytokines, adhesion molecules, some immunoglobulin superfamily members and mucin in PNI. Because PNI is often followed by poor survival. An earlier diagnosis can improve pancreatic cancer prognosis. IPEUS,CT scan and immunostaining CK-19, K-ras gene analysis can be used to diagnose perineural invasion pre-, intra-or postoperatively. A wide surgical exeresis with an enough lymph nodes clearance together with surrounding connective and nervous tissue can get a better long term survival rate.