Lu Meng, Xiu Dian-Rong, Guo Li-Mei, Yuan Chun-Hui, Zhang Ling-Fu, Tao Lian-Yuan
Department of Pulmonary Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, People's Republic of China.
Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China.
Onco Targets Ther. 2019 Dec 16;12:11083-11095. doi: 10.2147/OTT.S221844. eCollection 2019.
Pancreatic ductal adenocarcinoma has a devastatingly poor prognosis, and most prognostic factors reflected the tumor stage more than the tumors' biology. The peripheral nerve plexus is densely distributed in the tumor micro-environment, and there are interactions between tumor cells and these nerves. Perineural invasion is an important risk factor for tumor recurrence and metastasis in pancreatic head adenocarcinoma, but the concrete types of extrapancreatic neuropathy and its role in predicting prognosis are still not clear.
To clarify the role of extrapancreatic neuropathy in the early postoperative liver metastasis and tumor-related mortality in pancreatic head adenocarcinoma and to study the mechanism of tumor recurrence and liver metastasis in pancreatic head adenocarcinoma.
We reported a retrospective study of 60 patients with resectable pancreatic head adenocarcinoma, all of whom accepted radical pancreaticoduodenectomy. Plexus pancreaticus capitalis II (PLX-II) was the representation of extrapancreatic plexus in our study, and all of these plexus had immunohistochemical staining. We defined the postoperative tumor recurrence and tumor-related mortality within 6 months as the early prognostic indicators and analyzed the pathological alterations in PLX-II among different prognosis groups.
There were 18 patients suffering early postoperative liver metastasis; these two groups differed significantly in the average number of nerve trunks (P<0.001), the proportion of neuritis (P=0.003), the content of sympathetic nerve fibers (P=0.004) and parasympathetic nerve fibers (P<0.001) per unit area of PLX-II. There were 15 patients suffering early postoperative mortality, and there were significant differences between these two groups in the average number of nerve trunks (P<0.001), the proportion of neuritis (P=0.009), the content of sympathetic nerve fibers (P=0.023) and parasympathetic nerve fibers (P<0.001) per unit area of PLX-II.
The patterns of extrapancreatic neuropathy could reflect the biological behavior of resectable pancreatic head adenocarcinoma, and the pathological features of PLX-II were closely related to early liver metastasis and mortality.
胰腺导管腺癌预后极差，大多数预后因素更多反映的是肿瘤分期而非肿瘤生物学特性。外周神经丛密集分布于肿瘤微环境中，肿瘤细胞与这些神经之间存在相互作用。神经周围侵犯是胰头腺癌肿瘤复发和转移的重要危险因素，但胰外神经病变的具体类型及其在预测预后中的作用仍不明确。
阐明胰外神经病变在胰头腺癌术后早期肝转移及肿瘤相关死亡中的作用，并研究胰头腺癌肿瘤复发和肝转移的机制。
我们报告了一项对60例可切除性胰头腺癌患者的回顾性研究，所有患者均接受了根治性胰十二指肠切除术。在我们的研究中，胰头大神经丛II（PLX-II）是胰外神经丛的代表，所有这些神经丛均进行了免疫组织化学染色。我们将术后6个月内的肿瘤复发和肿瘤相关死亡定义为早期预后指标，并分析了不同预后组中PLX-II的病理改变。
有18例患者术后早期发生肝转移；这两组在PLX-II每单位面积的神经干平均数量（P<0.001）、神经炎比例（P=0.003）、交感神经纤维含量（P=0.004）和副交感神经纤维含量（P<0.001）方面存在显著差异。有15例患者术后早期死亡，这两组在PLX-II每单位面积的神经干平均数量（P<0.001）、神经炎比例（P=0.009）、交感神经纤维含量（P=0.023）和副交感神经纤维含量（P<0.001）方面存在显著差异。
胰外神经病变模式可反映可切除性胰头腺癌的生物学行为，PLX-II的病理特征与早期肝转移和死亡率密切相关。
