遠位胆管がんにおける神経‐腫瘍相互作用の解明 (Breakthrough in neural-tumor interactions in distal cholangiocarcinoma)

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2026-02-06 清華大学

清華大学長庚医院肝胆膵センターの董家鸿院士率いる研究チームは、遠位胆管癌(dCCA)における腫瘍―神経相互作用の解明で大きな成果を挙げた。研究では、Xeniumサブセルラー分解能の空間トランスクリプトミクスを初めて適用し、神経周囲浸潤(PNI)微小環境の高解像度空間細胞アトラスを構築した。20種類以上、35万細胞超を統合解析することで、PNIが単なる受動的浸潤ではなく、腫瘍細胞が神経親和性を獲得する「神経教育」過程であることを示した。さらにPNI密度指数を提案し、PNI高値腫瘍では神経新生、軸索再生、線維化、免疫抑制関連経路が顕著に活性化することを解明。CLDN18やMUC1などの分子マーカーも同定され、精密手術や治療標的化への応用が期待される。

遠位胆管がんにおける神経‐腫瘍相互作用の解明 (Breakthrough in neural-tumor interactions in distal cholangiocarcinoma)

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細胞内空間アトラスは遠位胆管癌における神経周囲浸潤の微小環境リモデリングを明らかにする A subcellular spatial atlas illuminates the microenvironmental remodeling of perineural invasion in distal cholangiocarcinoma

Fansen Ji,Hao Chen,Huan Li,Jiawei Zhang,Sijia Li,Pengfei Wang,Hao Liu,Cui Ge,Bingjun Tang,Hongfang Yin,Xuedong Wang & Jiahong Dong
Journal of Hematology & Oncology  Published:08 January 2026
DOI:https://doi.org/10.1186/s13045-025-01773-4

Abstract

Distal cholangiocarcinoma (dCCA) arises from the distal bile duct and is anatomically embedded within the pancreatic head, adjacent to abundant autonomic nerve plexuses. This unique location renders dCCA particularly prone to perineural invasion (PNI), a pathological hallmark that contributes to its dismal prognosis. However, the spatial architecture and molecular drivers that orchestrate PNI remain poorly defined. Here, we applied Xenium subcellular resolution spatial transcriptomics platform to profile resected tumor tissues from dCCA patients stratified by PNI status pathologically. A spatially resolved atlas comprising a total of 20 cell types was generated, uncovering enrichment of Schwann cells, type 2 conventional dendritic cells (cDC2), M2-like macrophages, cancer associated fibroblasts (CAFs) and B/plasma cells in PNI-high tumors, along with depletion of exhausted CD8+ T cells. Heterogeneous malignant cells in PNI-high tumors demonstrated activation of extracellular matrix remodeling and axonogenesis pathways, in line with the initial pathological classification. Spatial mapping further revealed distinct PNI-associated niches, notably matrix-producing CAFs (mCAFs)-macrophage clusters exhibiting coordinated enrichment of inflammatory and fibrotic programs. We further identified the LAMB3-DAG1 axis as a potential mediator of dCCA cells-Schwann cell interaction, while the preferential proximity of arteries to Schwann cells suggested additional microenvironmental support for nerve invasion. Collectively, our study provides a comprehensive subcellular atlas of PNI in dCCA, uncovering coordinated epithelial, stromal, and immune remodeling that drives perineural invasion. The identified biomarkers not only hold promise for patient stratification but may also guide intraoperative navigation and surgical margin determination, offering new avenues for precision therapy.

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