纳米刀治疗胰腺癌的研究进展

The progress of nanoknife in the treatment of pancreatic cancer

胰腺癌是一种恶性程度极高的消化道实体肿瘤,具有起病隐匿,早期诊断困难,肿瘤侵袭性强等特点,临床上多数患者就诊时已处于胰腺癌局部进展期或存在远处转移,缺乏根治性手术切除机会,治疗效果有限。不可逆电穿孔(也称纳米刀)是一种新的肿瘤消融治疗技术,通过两个电极针之间的高频电脉冲形成肿瘤消融区,在肿瘤细胞膜表面打出纳米级别孔隙,致使细胞内环境失衡,引起肿瘤细胞凋亡。相较传统的物理治疗方法,纳米刀具有无热副损伤、无电离辐射、无管道损伤等优点。近期临床研究和实践表明,纳米刀是一种安全、有效的肿瘤消融方式,可有效消融胰腺癌组织。进一步研究表明纳米刀治疗可以改善胰腺癌肿瘤免疫微环境,增敏胰腺癌化疗和免疫检查点抑制剂疗效,但仍需进一步开展相关临床研究。本文主要就纳米刀的治疗原理、胰腺癌纳米刀治疗和联合免疫治疗相关研究进展进行综述。

Pancreatic cancer is a highly malignant solid tumor of the digestive tract,which has the characteristics of insidious onset,difficult early diagnosis,and strong tumor invasiveness.Clinically,most patients are already in the locally advanced stage of pancreatic cancer or have distant metastasis when they visit the clinic,and lack the opportunity for radical surgical resection,and the treatment effect is limited.Irreversible electroporation(also known as nanoknife)is a new technique for tumor ablation.The ablation area is formed by high-frequency electrical pulses between two electrodes and needles,and nanoscale pores are punched out on the surface of tumor cell membrane,resulting in the imbalance of intracellular environment and the apoptosis of tumor cells.Compared with the traditional physical therapy method,nanoknife has no thermal damage,no ionizing radiation,no pipe damage and other advantages.Recent clinical studies and practice have shown that nanoknife is a safe and effective tumor ablation method,which can effectively ablate pancreatic cancer tissue.Further studies have shown that nanoknife therapy can improve the immune microenvironment of pancreatic cancer,sensitize the efficacy of pancreatic cancer chemotherapy and immune checkpoint inhibitors,but further relevant clinical studies are still needed.This article mainly reviews the principle of nanoknife therapy,the research progress of pancreatic cancer nanoknife therapy and combined immunotherapy.