摘要
随着分子病理学和针对特定基因改变的治疗方法发展,对胰腺疾病分子改变的认识越来越受到重视,其有助于对患者的预后和特定治疗的反应进行区分。手术切除的样本是DNA、RNA等遗传信息的主要来源,但只能代表少数(<20%)的胰腺癌患者,因为大多数胰腺疾病无需手术,且大多数胰腺癌患者发现即晚期,无法行手术治疗。因此,一种新的胰腺患病组织获取和分析的方法对于开发临床应用的分子标志物至关重要。内镜超声引导下细针穿刺术可以精准地将穿刺针刺至胰腺病变,通过细针穿刺抽取进行组织学、细胞学及基因学检查,以引领胰腺疾病的精准诊疗。随着穿刺针及高通量测序技术的不断发展,这项技术能够获得大量高质量的胰腺组织,不仅可用于诊断,也可用于基因突变和转录组评估以及进行原代细胞或组织培养,进而指导临床个体化治疗。文章阐述了内镜超声引导下细针穿刺术获取胰腺样本进行分子诊断的进展,以及它在疾病模型(如异种移植或类器官等)开发中的应用。
With the development of molecular pathology and treatments for specific gene mutations, the understanding of molecular changes in pancreatic diseases has been paid more and more attention, which helps to distinguish the patients’ prognosis and their response to a specific treatment. The samples obtained by surgry are the main source of genomic DNA,but they can only represent a small number(< 20%)of patients with pancreatic cancer, because most pancreatic diseases do not require surgery, and most patients with pancreatic cancer are found to be advanced and cannot be treated by surgery.Therefore, the application of a new method of tissue acquisition and analysis of pancreatic disease is essential for the development of molecular markers for clinical tissues for applications. Endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)can accurately puncture the needle to pancreatic lesions, and collect histological, cytological and genetic examinations, so as to lead the precise diagnosis and treatment of pancreatic diseases. With the development of puncture needle and high-throughput sequencing technology, this technology can obtain a large number of high-quality pancreatic tissues, which can be used not only for diagnosis, but also for gene mutation and transcriptome evaluation, as well as primary cell or tissue culture, guiding clinical individualized treatment. This article describes the progress of EUS-FNA to obtain pancreatic samples for molecular diagnosis, and its application in the development of disease models(such as xenografts or organoids).
作者
杨帆
杨飞
孙思予
YANG Fan;YANG Fei;SUN Si-yu(Department of Gastroenterology,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2021年第5期353-357,共5页
Chinese Journal of Practical Internal Medicine
基金
国家重点研发计划(2017YFC0109803)
辽宁省中央引导地方科技发展专项(2018107003)
中国博士后基金面上项目(2020M670101ZX)
辽宁省博士科研启动基金计划项目(2019-BS-276)
沈阳市科技计划专项(19-112-4-103)。
关键词
超声内镜
胰腺疾病
精准诊疗
endoscopic ultrasound
pancreatic diseases
precise diagnosis and treatment
