近红外荧光分子探针在胰腺癌分子成像中的研究进展

doi:10.3877/cma.j.issn.1674-3946.2026.06.020

胰腺癌是一种恶性程度高、预后极差的消化系统实体肿瘤。根治性手术切除仍是其主要治疗方式，而分期低估、切缘阳性和高复发率是影响其临床疗效的重要因素。传统的影像学检查在微小病灶检出、精确分期与术中切缘评估方面仍存在不足。近红外（NIR）荧光成像作为一种新型的分子成像技术，具有实时、灵敏、无电离辐射及易与腹腔镜/手术机器人平台集成等优势，已被推荐应用于诸多消化系统良恶性肿瘤的手术治疗；其中第二近红外窗口（NIR-Ⅱ，1 000~1 700 nm）更因其组织穿透深度深、时空分辨率高、信噪比优及可实时可视化等优势，可为胰腺癌的精准诊断与术中导航提供了新的技术路径。此外，近红外荧光分子探针作为近红外成像技术的关键核心，其性能直接决定了成像效果与应用前景。本文将围绕近红外荧光分子探针在胰腺癌分子成像中的设计策略、成像靶点及其在诊疗一体化平台构建中的应前沿进展进行综述。

关键词: 胰腺肿廇, 胰腺癌根治性切除术, 近红外荧光成像术, 近红外分子探针

Pancreatic cancer is a highly malignant and extremely unfavorable prognosis solid tumor of the digestive system. Radical surgical resection remains the main treatment method for it, while underestimation of staging, positive surgical margins, and high recurrence rate are important factors affecting its clinical efficacy. Traditional imaging examinations still have deficiencies in detecting small lesions, precise staging, and intraoperative margin assessment. Near-infrared (NIR) fluorescence imaging, as a new molecular imaging technology, has advantages such as real-time, sensitivity, no ionizing radiation, and easy integration with laparoscopic/surgical robot platforms. It has been recommended for application in the surgical treatment of many benign and malignant tumors of the digestive system. Among them, the second near-infrared window (NIR-Ⅱ, 1000-1700 nm) can provide a new technical path for precise diagnosis and intraoperative navigation of pancreatic cancer due to its advantages such as deep tissue penetration depth, high spatial resolution, excellent signal-to-noise ratio, and real-time visualization. In addition, near-infrared fluorescence molecular probes, as the key core of near-infrared imaging technology, their performance directly determines the imaging effect and application prospects. This article will review the design strategies, imaging targets, and their application in the construction of a diagnosis and treatment integrated platform of near-infrared fluorescence molecular probes in pancreatic cancer molecular imaging.

Key words: Pancreatic Neoplasm, Radical Resection of Pancreatic Cancer, Near-Infrared Fluorescence Imaging, Near-Infrared Molecular Probe

表1 NIR-Ⅰ与NIR-Ⅱ的临床特性比较^{[9,10,11,12,13]}

项目	NIR-Ⅰ	NIR-Ⅱ
成像窗口	650~950 nm	1000~1700 nm
组织穿透力	通常≤3 mm	可达5~10 mm以上
空间分辨率	受散射限制，分辨率一般在几十微米级	散射降低可使分辨率提升至10 μm级别
信噪比	较高自体荧光与散射导致信噪比较低	组织在NIR-II区自发荧光极低，光子散射大幅减少
光稳定性	部分有机染料易光漂白，稳定性一般	新型无机探针（如量子点、稀土纳米颗粒）光稳定性较好
浓度淬灭	传统有机染料在高浓度下易发生荧光淬灭	部分新材料（如聚集诱导发光AIE探针、特定纳米结构）可减轻浓度淬灭效应
临床转化状态	已临床应用（ICG为代表）	多数处于临床前研究阶段

表1 NIR-Ⅰ与NIR-Ⅱ的临床特性比较^{[9,10,11,12,13]}

项目	NIR-Ⅰ	NIR-Ⅱ
成像窗口	650~950 nm	1000~1700 nm
组织穿透力	通常≤3 mm	可达5~10 mm以上
空间分辨率	受散射限制，分辨率一般在几十微米级	散射降低可使分辨率提升至10 μm级别
信噪比	较高自体荧光与散射导致信噪比较低	组织在NIR-II区自发荧光极低，光子散射大幅减少
光稳定性	部分有机染料易光漂白，稳定性一般	新型无机探针（如量子点、稀土纳米颗粒）光稳定性较好
浓度淬灭	传统有机染料在高浓度下易发生荧光淬灭	部分新材料（如聚集诱导发光AIE探针、特定纳米结构）可减轻浓度淬灭效应
临床转化状态	已临床应用（ICG为代表）	多数处于临床前研究阶段

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