分子靶向时代胰腺癌综合诊治的现状与展望

Current research status and progress in comprehensive diagnosis and treatment of pancreatic cancer in the era of targeted therapy

胰腺癌发病率呈上升趋势,以早期诊断困难、手术切除率低及预后差为特点,临床诊治极具挑战性。由于其遗传异质性显著,不同患者之间在疾病进展、临床疗效、放化疗敏感性及预后等方面差异巨大,深入探讨胰腺癌分子生物学特征及其与临床表现、放化疗敏感性的相关性,研发相应的靶向药物,是胰腺癌从传统形态学分型转变到分子分型的重要基础,也是实现从"异病同治"到"同病异治"精准治疗模式转变的前提。在分子靶向时代,胰腺癌的治疗模式转变为综合诊治,有望成为胰腺癌治疗的突破口。

The incidence of pancreatic cancer(PC)has continuously shown an upward trend all over the world.It remains one of the most challenging malignant tumors in clinical practice and is characterized by difficult diagnosis in early stages,low surgical resection rate and poor prognosis.Due to its significant genetic heterogeneity,there are notable individual differences in disease progression,clinical efficacy,sensitivity to chemoradiotherapy,and prognosis among PC patients.In-depth study is needed to reveal the molecular biological characteristics of different PC subtypes and their correlation with clinical manifestations and chemoradiotherapy sensitivity,which could contribute to develop corresponding targeted therapeutic strategies.It is not only the fundamental basis for the innovation of PC morphological classification to molecular subtyping,but also a prerequisite for achieving a shift in treatment mode from"standard therapeutic strategy for different diseases"to"treat the same disease with different strategies".This article reviews several hot issues on the comprehensive diagnosis and treatment of PC in the era of targeted therapy and prospects its future development.