干细胞移植治疗复杂性肛瘘的研究进展

Progress of stem cell transplantation for treating complex anal fistula

目的了解干细胞移植在治疗复杂性肛瘘领域的研究进展情况。方法通过检索PubMed、Web of Science、CNKI、万方等数据库中有关干细胞移植在复杂性肛瘘领域应用的相关文献,对该疗法的临床疗效及优势或存在的问题进行分析总结。结果目前应用于复杂性肛瘘领域的干细胞主要是来源于脂肪组织的干细胞,它具有再生分化、免疫调节及修复肠黏膜屏障的生物学特性,其可作为种子细胞应用于复杂性肛瘘的治疗,其有效性值得肯定,但其临床治疗方案存在差异且缺乏统一的标准,其远期临床疗效有待观察;并且由于干细胞具有癌基因激活、抑癌基因失活的特性,其治疗复杂性肛瘘的安全性备受关注。结论干细胞移植作为一种新兴的疗法,特别是对于难以通过手术解决的复杂性肛瘘患者具有广泛的前景,但其远期疗效仍不尽如人意。由于目前研究的样本量较少、观察时间较短且缺乏随机对照等问题,使得目前临床数据缺乏信服力,同时成本高也限制了该技术的发展。

Objective To understand progress of stem cell transplantation in treatment of complex anal fistula.Method The relevant literatures were searched in the PubMed, Web of Science, CNKI, Wanfang, and other databases and the clinical efficacy, advantages and problems of the therapy were analyzed and summarized. Results The stem cells currently used in the field of complex anal fistula were mainly the adipose tissue-derived stem cells, which had the biological characteristics of regenerative differentiation, immune regulation, and repair of intestinal mucosal barrier,which could be used as the seed cells for the treatment of complex anal fistula, its effectiveness was worthy of recognition.But its long-term clinical efficacy remained to be seen due to its clinical treatment options were different and lack of uniform standards. The safety of treatment for complex anal fistula was payed a attention because the stem cells had the oncogene activation and tumor suppressor gene inactivation characteristics. Conclusions Stem cell transplantation, as an emerging therapy, has broad prospects for patients with complex anal fistula that are difficult to solve by surgery, but its long-term efficacy is still unsatisfactory. Due to current sample size, short observation time, and lack of randomized control, current clinical data is not convincing, and high cost also limits its development of technology.