摘要
目的了解神经周围侵犯(perineural invasion,PNI)对结直肠癌发生、发展及预后的影响,为结直肠癌的诊断和治疗提供参考。方法对国内外关于PNI在结直肠癌中的发生机制、诊断、治疗及预后影响研究的文献进行分析。结果目前研究表明,PNI的发生机制涉及神经生长因子、趋化因子及其他信号分子,通过调控神经与癌细胞的相互作用促进肿瘤侵袭和转移。诊断方面,组织病理学检查仍为主要方法,结合免疫组织化学染色和影像组学技术可提高PNI诊断的准确性。治疗上,伴PNI的CRC患者能获益于手术结合新辅助或辅助治疗,靶向神经相关分子通路和免疫检查点抑制剂(如程序性死亡蛋白1、细胞毒性T淋巴细胞相关蛋白4)在减少PNI及抑制肿瘤进展方面表现出潜力,阻断神经纤维与肿瘤相互作用的治疗策略正逐步成为新兴方向。PNI被明确为结直肠癌患者预后的重要指标,对评估生存风险和制定个体化治疗策略具有指导意义。结论PNI是结直肠癌预后评估的重要指标之一,对治疗决策具有指导作用。进一步深入研究PNI的分子机制和早期诊断手段,可为结直肠癌患者提供更有效的治疗方案,并有望改善结直肠癌患者的预后。
Objective To comprehend the impact of perineural invasion(PNI)on the occurrence,development,and prognosis of colorectal cancer(CRC),providing a reference for the diagnosis and treatment of CRC.Method The latest literature relevant researches on the mechanism,diagnosis,treatment,and prognosis of PNI in CRC both domestically and internationally was reviewed.Results The mechanisms underlying PNI involved nerve growth factors,chemokines,and other signaling molecules,which regulated the interactions between the nerves and cancer cells to promote the tumor invasion and metastasis.The diagnostic approaches primarily relied on the histopathological examination with immunohistochemistry and radiomics.Therapeutically,the PNI-positive patients benefited from surgical intervention in combination with neoadjuvant or adjuvant treatment.Targeting the neural pathways and immune checkpoint inhibitors(such as programmed cell death 1 and cytotoxic T lymphocyte associated protein 4 inhibitors)showed potentials in reducing neural invasion and tumor progression.Emerging strategies that disrupted tumor-nerve interactions also represented promising therapeutic avenues.The PNI was recognized as a critical prognostic indicator for CRC,providing guidance in risk assessment and individualized treatment planning.Conclusions PNI serves as an important indicator for evaluating the prognosis of CRC,it has a guiding value for therapy decision-making.Further research of molecular mechanisms and diagnostic methods relevant PNI can potentially yield more effective therapeutic options and is expected to improve prognosis of patients with CRC.
作者
李彦杰
于建平
王虹宇
王进宝
杨高升
韩晓鹏
LI Yanjie;YU Jianping;WANG Hongyu;WANG Jinbao;YANG Gaosheng;HAN Xiaopeng(The First School of Clinical Medical,Gansu University of Chinese Medicine,Lanzhou 730000,P.R.China;Department of General Surgery,Gansu Provincial Central Hospital,Lanzhou 730070,P.R.China)
出处
《中国普外基础与临床杂志》
2025年第2期258-264,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
甘肃省科技计划项目-基础研究计划(项目编号:23JRRA1386)
兰州市科技计划项目(项目编号:2023-4-65)。
关键词
结直肠癌
神经周围侵犯
机制
诊断
治疗
预后
综述
colorectal cancer
perineural invasion
mechanism
diagnosis
treatment
prognosis
review
