近年来，我国的胰腺外科得到了长足发展，特别是在北京、上海、武汉等一些大城市相继成立了胰腺外科诊治中心，提高了诊治胰腺疾病的临床和科研水平，在胰腺癌的诊治方面尤为突出，有关胰腺癌诊治的基础与临床研究均取得较大的进展。2002年9月在大连成功地召开了“第九届全国胰腺外科学术研讨会”，许多专家、学者介绍了他们在胰腺癌诊治方面的成功经验，代表了我国胰腺癌诊治的水平和现状。同时，在近年的普通外科期刊中，关于胰腺癌的诊治现状和进展类文章很多，这些文章都高度概括了胰腺癌的诊治重点是早期诊断和综合治疗。然而，在胰腺癌的研究中还存在一些问题和误区，有必要对其作深入的探讨，使我们的工作在科研上更系统化，在临床工作中更加规范化。
慢性胰腺炎是一种胰腺的进展性和不可逆性炎症病变，最终将导致胰腺结构破坏和内、外分泌功能的丧失。病程通常呈反复发作性，表现为复发性腹痛或慢性无痛综合征。急性胰腺炎、慢性胰腺炎和胰腺癌这三种疾病之间存在着较复杂的关系。急性胰腺炎的发作通常先于慢性胰腺炎几年时间，而胰腺癌往往是在慢性胰腺炎明确诊断后20年左右发生，关于他们在发病上是否存在着一定的序贯性或是有其他短暂的联系，目前仍有争论。一些资料完整的临床病例随访分析提示，长期患慢性胰腺炎的患者发展为胰腺癌的危险性明显高于普通人群。
近年来，对胰腺癌虽然在诊断技术和治疗手段上有了长足的进步，但胰腺癌患者的生存时间并没有延长。常规的治疗手段中，手术仍是达到治愈的唯一手段，但85%的患者在确诊时癌肿已转移或侵袭到胰外器官而无法切除； 放疗和化疗对其尚缺乏确切的疗效。因此，寻求新的、有效的治疗方法是基础研究者和临床医生共同努力的方向。随着肿瘤免疫学和分子生物学研究的进展及人类基因组计划的完成，人们已经对肿瘤的发生、发展和转移机理有了一定的了解。与此同时，基础研究的成果也大大推动了临床研究的进程。20世纪在肿瘤的生物治疗方面取得了不少进展，主要集中在基因治疗、免疫毒素、肿瘤疫苗和细胞因子等方面。
Objective To investigate the role of Notch signaling pathway in pancreas development and pancreatic cancer. Methods The related literatures were reviewed and analyzed. Results Notch signaling played a role early in development by maintaining pancreatic epithelial cells in a progenitor state and delaying their differentiation until timely appropriate. Notch signaling was reactivated in the initiation and progression of pancreatic cancer. Conclusion Notch signaling pathway plays an important role in the pancreas development. Sustained Notch signaling activity promotes the progression of pancreatic cancer, and may be one of major factors in the initiation of pancreatic cancer.
ObjectiveTo investigate the growth characteristics of pancreatic cancer cells in the twodimensional culture system (monolayer) and threedimensional culture system (type Ⅰ collagen and extracellular matrix gel). MethodsThree pancreatic cancer cell lines (SW1990, PCT, and ASPC1) were cultured in monolayer, type Ⅰ collagen, and extracellular matrix gel, respectively. The growth patterns were observed, growth curves were detected by CCK8 test, and the cell cycle distributions were analyzed by propidium iodide staining. Results In the twodimensional culture system, cells grew in monolayer. In the type Ⅰ collagen and the ECM gel threedimensional culture system, cells formed multicellular spheroids (MCS), of which the growth rates were slower than those of the cells in monolayer. The proportions of S phase of SW1990, PCT, and ASPC1 cells in twodimensional culture system were significantly more than those in the type Ⅰ collagen on 4 d and 8 d 〔(29.6±3.0)% vs. (18.2±5.1)%, (33.6±2.1)% vs. (14.5±3.2)%, (33.1±1.8)% vs. (24.7±2.6)%; Plt;0.05〕, while the difference of proportion of three cell lines in G2/M phase was not different between twodimensional culture system and type Ⅰ collagen (Pgt;0.05). The proportions of G0/G1 phase of SW1990 and PCT cells cultured in the type Ⅰ collagen on 4 d and 8 d and ASPC1 cells cultured in the type Ⅰ collagen on 4 d were significant more than those cultured in twodimensional culture system (Plt;0.05). The proportions of S phase of ASPC1 cells and SW1990 cells cultured in the type Ⅰ collagen on 4 d were significant more than those cultured in the type Ⅰ collagen on 8 d (Plt;0.05). ConclusionsThe characteristics of pancreatic cancer cells in twodimensional and threedimensional culture systems are different. MCS culture system can better mimic the in vivo growth environment of cells in tumors.