胰腺导管腺癌间质纤维化靶向治疗和无创评估的研究现状

Progress in the non-invasive evaluation of interstitial fibrosis and targeted therapy for pancreatic ductal adenocarcinoma

胰腺导管腺癌是恶性程度最高的实体肿瘤之一,其重要的病理组织学特征是在肿瘤进展过程中动态演变的肿瘤间质纤维化。丰富的细胞外基质成分促进肿瘤缺氧进而恶性进展以及形成耐药性。近年来,越来越多的研究丰富了临床对胰腺导管腺癌间质纤维化的生物学和病理生理学的认识和理解,最近的研究结果表明,肿瘤纤维化间质可能具有抑制肿瘤特性,这使得明确其作用更具挑战性。胰腺导管腺癌治疗前后使用影像技术来无创评估间质纤维化程度具有巨大的潜力,尚在研究中的一些间质靶向治疗方法可能有助于改善患者的不良预后。

Pancreatic ductal adenocarcinoma(PDAC)is one of the most malignant solid tumors.Its important histological feature is the dynamically evolving tumor fibrotic stroma during tumor progression.Abundant extracellular matrix components promote tumor hypoxia and subsequent progression as well as drug resistance.An increasing number of studies have enriched the clinical understanding of biology and pathophysiology of interstitial fibrosis in PDAC.Emerging findings suggest that components of the tumor fibrotic stroma may have tumor-suppressive properties,making it more challenging to clarify its role.The use of imaging techniques to assess the degree of interstitial fibrosis in PDAC non-invasively has great potential,and some new stroma-targeted therapeutic approaches may help to improve the poor prognosis of patients in the future.