胰腺肿瘤神经生态学：多维视角下的现状、机制与展望

郑上游; 江宏辉; 胡崇辉; 李婷婷; 黄天浩; 何日华; 蒋勇; 陈汝福

doi:10.12449/JCH250403

胰腺肿瘤神经生态学：多维视角下的现状、机制与展望

DOI: 10.12449/JCH250403

郑上游¹,
江宏辉¹,
胡崇辉¹,
李婷婷^{1, 2},
黄天浩¹,
何日华¹,
蒋勇¹,
陈汝福^{1, 2, 3, , ,}

1.
广东省人民医院（南方医科大学附属广东省人民医院，广东省医学科学院）普外科胰腺中心，广州 510080
2.
华南理工大学医学院，广州 510006
3.
广东省心血管病研究所，广州 510080

基金项目:

国家自然科学基金 (82372859);

国家自然科学基金 (82372858)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：郑上游、江宏辉、胡崇辉负责资料查找，撰写论文；李婷、黄天浩、何日华、蒋勇负责修改与校对论文；陈汝福指导修改论文并最终定稿。

详细信息

通信作者:
陈汝福， chenrufu@gdph.org.cn （ORCID： 0009-0009-7422-5222）

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出版历程
- 收稿日期: 2025-03-20
- 录用日期: 2025-04-05
- 出版日期: 2025-04-25

Pancreatic cancer neuroecology： Current status， mechanisms， and prospect from multi-dimensional perspectives

1.
Pancreas Center，Department of General Surgery，Guangdong Provincial People’s Hospital （Guangdong Provincial People’s Hospital Affiliated to Southern Medical University，Guangdong Academy of Medical Sciences），Guangzhou 510080，China
2.
School of Medicine，South China University of Technology，Guangzhou 510006，China
3.
Guangdong Cardiovascular Institute，Guangzhou 510080，China

Research funding:

National Natural Science Foundation of China (82372859);

National Natural Science Foundation of China (82372858)

More Information

Corresponding author: CHEN Rufu， chenrufu@gdph.org.cn （ORCID： 0009-0009-7422-5222）

摘要

摘要: 胰腺癌具有显著的神经侵袭性与高致死率特征，其病理进程依赖于肿瘤与神经系统之间复杂的相互作用网络。本文基于“胰腺肿瘤神经生态学”概念，系统梳理了外周运动神经、感觉神经及中枢神经在肿瘤发生、疼痛调控及恶病质形成中的作用机制，强调了免疫细胞、施旺细胞与细胞外基质在神经浸润微环境中的协同调控作用。同时，进一步阐释了神经轴与肿瘤之间的代谢相互作用、趋化行为及其对化疗耐药的促进效应，揭示了神经可塑性与肿瘤适应性之间的动态关系。在临床层面，本文总结了神经浸润在胰腺癌患者预后评估、术前评估及手术策略选择中的关键价值。此外，本文归纳了胰腺癌神经浸润相关生物标志物与潜在靶点的基础研究进展，并指出当前模型与转化研究的局限性。未来，系统解析神经-肿瘤-免疫网络并靶向其关键节点，有望为胰腺癌的精准干预、耐药逆转及症状缓解提供多维策略与新突破。
- 胰腺肿瘤 /
- 神经系统 /
- 生态学
Abstract: Pancreatic cancer is characterized by nerve invasion and a high mortality rate， and its pathological process depends on the complex interaction network between tumor and the nervous system. Based on the concept of “pancreatic cancer neuroecology”， this article analyzes the mechanism of action of peripheral motor nerve， sensory nerve， and central nerve in tumorigenesis， pain regulation， and cachexia formation and emphasizes the synergistic regulatory role of immune cells， Schwann cells， and extracellular matrix in the microenvironment of perineural invasion. At the same time， this article further elaborates on the metabolic interaction and chemotaxis between neuraxis and tumor， the effect on promoting chemotherapy resistance， and the dynamic relationship between neuroplasticity and tumor adaptability. In clinical practice， this article summarizes the key value of perineural invasion in prognostic evaluation， preoperative evaluation， and the selection of surgical strategy. In addition， this article reviews the basic research advances in the biomarkers and potential targets associated with perineural invasion in pancreatic cancer and points out the limitations of current model and transformation research. In the future， systematically analyzing the nerve-tumor-immune network and targeting its key nodes may provide multi-dimensional strategies and new breakthroughs for the precise intervention of pancreatic cancer， the reversal of drug resistance， and the relief of symptoms.
- Pancreatic Neoplasms /
- Nervous System /
- Ecology

HTML全文

注： CCL2，C-C基序配体2；PNI，神经浸润；CAF，癌相关成纤维细胞；CNS，中枢神经系统。

图 1 胰腺肿瘤神经生态学机制图

Figure 1. Neuroecological mechanism map of pancreatic tumor

下载: 全尺寸图片幻灯片

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