嗜神经侵袭在妇科恶性肿瘤中的研究进展

doi:10.3969/j.issn.1006-5725.2025.12.023

Abstract

Abstract:

As a distinct pathological factor and metastatic route of malignant tumors， perineural invasion （PNI） exhibits a close association with the prognosis of several cancer types. In recent years， the clinical significance and underlying mechanisms of PNI in gynecological malignant tumors have increasingly drawn research attention. Currently， it is recognized that PNI is clinicopathologically and prognostically linked to cervical cancer and vulvar cancer. The exploration of its mechanisms encompasses multiple gynecological tumors and numerous molecular pathways， including the CCL2/CCR2 axis， NGF/TrkA pathway， GluR2， among others. Nevertheless， the existing research models are fragmented， lacking systematicity and in-depth analysis， thus necessitating integration. This paper presents a comprehensive review of the occurrence of PNI in gynecologic malignancies， its correlations with clinicopathology and prognosis， its implications for surgical approaches and postoperative adjuvant therapies， as well as the potential molecular mechanisms. By synthesizing the advancements in both clinical and basic research， this review aims to offer a solid theoretical foundation for further exploration of the mechanisms underlying PNI in gynecologic malignancies and for the optimization of clinical therapeutic strategies.

Key words: perineural invasion, cervical cancer, vulvar carcinoma, ovarian cancer, endometrial cancer

CLC Number:

R737.3

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.

Figures/Tables 2

Tab. 1

Tab.2

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作者及发表年份	PNI发生率	临床病理因素
作者及发表年份	PNI发生率	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^［19］	41.7%（15/36）	/	+	+	-	/	/	/	/	/	+
HORN 2010^［14］★ MEINEL 2011^［15］★	35.1%（68/194）	/	+	+	/	/	/	/	/	+	/
ELSAHWI 2011^［10］	12.5%（24/192）	+	-	-	+	-	-	+	-	+	+
CHO 2013^［16］	7.0%（13/185）	+	+	+	+	+	/	-	/	+	/
SKRET?MAGIERLO 2014^［12］	18%（9/50）	-	+	-	-	/	/	+	-	+	/
张国楠 2015^［3］	9.2%（22/238）	+	+	+	+	-	-	+	-	-	/
WEI 2016^［13］	16.0%（33/206）	/	+	+	+	/	-	+	+	+	/
VURAL 2017^［4］	30.6%（34/111）	+	+	+	+	+	-	+	/	+	/
ZHU 2018^［5］	8.6%（18/210）	+	+	+	+	-	-	+	-	-	/
祖新慧 2018^［17］	9.5%（48/506）	-	+	+	+	+	-	-	-	-	/
TANG 2019^［18］	10.59%（43/406）	/	+	+	+	+	-	-	/	-	/
刘涛 2020^［6］	14.2%（65/457）	-	+	+	+	/	/	+	/	+	/
WAN 2021^［11］	8.8%（162/1836）	+	+	+	-	+	-	-	-	-	-
GAO 2024^［7］	16.5%（70/423）	+	+	+	+	/	/	+	/	+	/
CHEN 2024^［8］	22.6%（273/1208）	+	+	+	+	-	+	-	/	-	/
CAI 2025^※［9］	12.1%	+	+	+	+	+	/	+	/	+	/
外阴癌
HOLTHOFF 2015^［26］	52.4%（54/103）	/	+	-	-	/	/	/	/	-	/
LONG 2019^［22］	28.6%（30/105）	/	+	-	+	-	/	+	-	-	/
SALCEDO 2019^［27］	7.6%（32/421）	/	/	+	+	+	-	/	/	+	/
FERRARI 2019^［23］	31.1%（23/74）	/	-	+	+	-	/	+	-	+	/
GADDUCCI 2021^［24］	25%（16/64）	/	-	+	+	/	/	+	-	+	/
MICHELETTI 2022^［25］	59.6%（133/223）	/	+	+	+	-	/	+	+	+	/

作者及发表年份	患者例数		预后分析
	患者例数		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^［3］	22	216	缩短	非独立危险因素	缩短	非独立危险因素	-	-
KWON 2016^［31］	7	43	无关	非独立危险因素	缩短	非独立危险因素	-	-
VURAL 2017^［4］	34	77	缩短	-	无关	-	-	非独立危险因素
ZHU 2018^［5］	18	192	缩短	非独立危险因素	缩短	非独立危险因素	-	-
祖新慧 2018^［17］	48	458	无关	-	-	-	RFS缩短	复发独立危险因素
TANG 2019^［18］	43	363	缩短	独立危险因素	缩短	独立危险因素	-	-
刘涛 2020^［6］	65	392	缩短	独立危险因素	-	-	PFS缩短	复发独立危险因素
WAN 2021^［11］	162	1674	缩短	-	-	-	PFS缩短	-
CHEN 2024^［8］	273	935	缩短	独立危险因素	缩短	独立危险因素	-	-
CAI 2025^※［9］	-	-	缩短	独立危险因素	缩短	非独立危险因素	-	-
外阴癌
HOLTHOFF 2015^［26］	54	49	-	-	-	-	-	复发独立危险因素
BAIOCCHI 2015^［32］	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^［33］	-	-	缩短	独立危险因素	-	-	PFS无关、DSS缩短	DSS独立危险因素
SALCEDO 2019^［27］	32	389	缩短	独立危险因素	-	-	PFS缩短	PFS独立危险因素
FERRARI 2019^［23］	23	51	缩短	独立危险因素	缩短	-	-	复发独立危险因素
LONG 2019^［22］	30	75	缩短	非独立危险因素	缩短	非独立危险因素	-	-
GADDUCCI 2021^［24］	16	48	缩短	-	缩短	-	与复发、转移相关	-
MICHELETTI 2022^［25］	133	90	-	-	-	-	-	DSS独立危险因素
SANTORO 2022^※［34］	-	-	-	独立危险因素	-	-	-	PFS、DSS独立危险因素
PERGIALIOTIS 2022^※［35］	-	-	-	独立危险因素	-	-	-	PFS独立危险因素

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Research progress of perineural invasion in gynecological malignant tumors

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