实用医学杂志 ›› 2025, Vol. 41 ›› Issue (12): 1929-1935.doi: 10.3969/j.issn.1006-5725.2025.12.023
• 综述 • 上一篇
收稿日期:
2025-01-13
出版日期:
2025-06-25
发布日期:
2025-07-02
通讯作者:
龙颖
E-mail:longcljying@163.com
基金资助:
Yekun HE,Ying LONG(),Lizhang CEN,Desheng. YAO
Received:
2025-01-13
Online:
2025-06-25
Published:
2025-07-02
Contact:
Ying LONG
E-mail:longcljying@163.com
摘要:
嗜神经侵袭(perineural invasion, PNI)作为恶性肿瘤的一种特殊病理因素与转移途径,与多个癌种的预后密切相关。近年来,PNI在妇科恶性肿瘤中的临床意义及机制研究逐渐受到关注。目前认为PNI与宫颈癌、外阴癌临床病理、预后相关;机制研究则涉及多个妇科肿瘤及多个分子通路,如CCL2/CCR2轴、NGF/TrkA通路、GluR2等,但研究模式碎片化,不够系统深入,需要整合。该文就PNI在妇科恶性肿瘤中的发生、与临床病理和预后的关系、对手术方式和术后辅助治疗的指导,以及可能的分子机制作一综述,通过整合临床和基础研究进展,旨在为妇科恶性肿瘤PNI的相关机制探索及临床治疗策略优化提供一定的理论依据。
中图分类号:
何业坤,龙颖,岑立仗,姚德生. 嗜神经侵袭在妇科恶性肿瘤中的研究进展[J]. 实用医学杂志, 2025, 41(12): 1929-1935.
Yekun HE,Ying LONG,Lizhang CEN,Desheng. YAO. Research progress of perineural invasion in gynecological malignant tumors[J]. The Journal of Practical Medicine, 2025, 41(12): 1929-1935.
表1
宫颈癌和外阴癌PNI发生率及其与临床病理特征之间的关联"
作者及发表年份 | PNI发生率 | 临床病理因素 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
宫旁 浸润 | 间质浸润深度/ 浸润深度 | 淋巴结 转移 | LVSI | 切缘 阳性 | 组织学 类型 | 肿瘤 大小 | 肿瘤 分级 | 肿瘤 分期 | 子宫/阴道侵犯 | ||
宫颈癌 | |||||||||||
OZAN 2009[ | 41.7%(15/36) | / | + | + | - | / | / | / | / | / | + |
HORN 2010[ MEINEL 2011[ | 35.1%(68/194) | / | + | + | / | / | / | / | / | + | / |
ELSAHWI 2011[ | 12.5%(24/192) | + | - | - | + | - | - | + | - | + | + |
CHO 2013[ | 7.0%(13/185) | + | + | + | + | + | / | - | / | + | / |
SKRET?MAGIERLO 2014[ | 18%(9/50) | - | + | - | - | / | / | + | - | + | / |
张国楠 2015[ | 9.2%(22/238) | + | + | + | + | - | - | + | - | - | / |
WEI 2016[ | 16.0%(33/206) | / | + | + | + | / | - | + | + | + | / |
VURAL 2017[ | 30.6%(34/111) | + | + | + | + | + | - | + | / | + | / |
ZHU 2018[ | 8.6%(18/210) | + | + | + | + | - | - | + | - | - | / |
祖新慧 2018[ | 9.5%(48/506) | - | + | + | + | + | - | - | - | - | / |
TANG 2019[ | 10.59%(43/406) | / | + | + | + | + | - | - | / | - | / |
刘涛 2020[ | 14.2%(65/457) | - | + | + | + | / | / | + | / | + | / |
WAN 2021[ | 8.8%(162/1836) | + | + | + | - | + | - | - | - | - | - |
GAO 2024[ | 16.5%(70/423) | + | + | + | + | / | / | + | / | + | / |
CHEN 2024[ | 22.6%(273/1208) | + | + | + | + | - | + | - | / | - | / |
CAI 2025※[ | 12.1% | + | + | + | + | + | / | + | / | + | / |
外阴癌 | |||||||||||
HOLTHOFF 2015[ | 52.4%(54/103) | / | + | - | - | / | / | / | / | - | / |
LONG 2019[ | 28.6%(30/105) | / | + | - | + | - | / | + | - | - | / |
SALCEDO 2019[ | 7.6%(32/421) | / | / | + | + | + | - | / | / | + | / |
FERRARI 2019[ | 31.1%(23/74) | / | - | + | + | - | / | + | - | + | / |
GADDUCCI 2021[ | 25%(16/64) | / | - | + | + | / | / | + | - | + | / |
MICHELETTI 2022[ | 59.6%(133/223) | / | + | + | + | - | / | + | + | + | / |
表2
近10年PNI对宫颈癌和外阴癌预后影响的主要研究摘要"
作者及发表年份 | 患者例数 | 预后分析 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
OS | DFS | 其他 | ||||||||
PNI(+) | PNI(-) | 单因素分析 | 多因素分析 | 单因素分析 | 多因素分析 | 单因素分析 | 多因素分析 | |||
宫颈癌 | ||||||||||
张国楠 2015[ | 22 | 216 | 缩短 | 非独立危险因素 | 缩短 | 非独立危险因素 | - | - | ||
KWON 2016[ | 7 | 43 | 无关 | 非独立危险因素 | 缩短 | 非独立危险因素 | - | - | ||
VURAL 2017[ | 34 | 77 | 缩短 | - | 无关 | - | - | 非独立危险因素 | ||
ZHU 2018[ | 18 | 192 | 缩短 | 非独立危险因素 | 缩短 | 非独立危险因素 | - | - | ||
祖新慧 2018[ | 48 | 458 | 无关 | - | - | - | RFS缩短 | 复发独立危险因素 | ||
TANG 2019[ | 43 | 363 | 缩短 | 独立危险因素 | 缩短 | 独立危险因素 | - | - | ||
刘涛 2020[ | 65 | 392 | 缩短 | 独立危险因素 | - | - | PFS缩短 | 复发独立危险因素 | ||
WAN 2021[ | 162 | 1674 | 缩短 | - | - | - | PFS缩短 | - | ||
CHEN 2024[ | 273 | 935 | 缩短 | 独立危险因素 | 缩短 | 独立危险因素 | - | - | ||
CAI 2025※[ | - | - | 缩短 | 独立危险因素 | 缩短 | 非独立危险因素 | - | - | ||
外阴癌 | ||||||||||
HOLTHOFF 2015[ | 54 | 49 | - | - | - | - | - | 复发独立危险因素 | ||
BAIOCCHI 2015[ | 25 | 93 | - | - | 缩短 | 非独立危险因素 | 增加LRR风险 | 非独立危险因素 | ||
DIAS-SANTAGATA 2017[ | - | - | 缩短 | 独立危险因素 | - | - | PFS无关、DSS缩短 | DSS独立危险因素 | ||
SALCEDO 2019[ | 32 | 389 | 缩短 | 独立危险因素 | - | - | PFS缩短 | PFS独立危险因素 | ||
FERRARI 2019[ | 23 | 51 | 缩短 | 独立危险因素 | 缩短 | - | - | 复发独立危险因素 | ||
LONG 2019[ | 30 | 75 | 缩短 | 非独立危险因素 | 缩短 | 非独立危险因素 | - | - | ||
GADDUCCI 2021[ | 16 | 48 | 缩短 | - | 缩短 | - | 与复发、转移相关 | - | ||
MICHELETTI 2022[ | 133 | 90 | - | - | - | - | - | DSS独立危险因素 | ||
SANTORO 2022※[ | - | - | - | 独立危险因素 | - | - | - | PFS、DSS独立危险因素 | ||
PERGIALIOTIS 2022※[ | - | - | - | 独立危险因素 | - | - | - | PFS独立危险因素 |
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