“死亡荒漠”的“绿洲”:重视微卫星高度不稳定/错配修复缺陷胰腺癌的诊断与治疗

'Oasis'in'death desert':attach importance to the diagnosis and treatment for pancreatic cancer with microsatellite instability‐high/deficient mismatch repair

胰腺癌是预后较差的消化道恶性肿瘤,多数患者对传统化疗、靶向治疗及免疫治疗等策略不敏感。具有微卫星高度不稳定/错配修复缺陷(MSI⁃H/dMMR)特征的胰腺癌临床较为罕见,具有不同于常见胰腺癌的病理学特征并有较好预后。合理获取胰腺肿瘤病理学标本,准确评估其MSI⁃H/dMMR特征有助于患者的精确诊断。以免疫治疗为基础的个体化治疗能显著改善MSI⁃H/dMMR胰腺癌患者预后。笔者结合国内外文献,深入探讨MSI⁃H/dMMR胰腺癌的诊断与治疗现状以及研究热点。

Pancreatic cancer(PC)is a malignant digestive tract tumor with poor prognosis.Most of patients with PC are insensitive to traditional strategies of chemotherapy,targeted therapy and immunotherapy.PC with microsatellite instability‐high/deficient mismatch repair(MSI‐H/dMMR)is rare in clinic,which has distinctive clinicopathological characteristics and better prognosis from conventional PC.Reasonable acquisition of pancreatic tumor biopsy and accurate assessment of MSI‐H/dMMR status are helpful for accurate diagnosis of such patients.Individualized treatment strategy based on immunotherapy can significantly improve the prognosis of patients with MSI‐H/dMMR PC.Based on relevant literatures of domestic and foreign,the authors discuss the current status and research hotspots of diagnosis and treatment for MSI‐H/dMMR PC.