Perineural invasion (PNI) in pancreatic cancer,as an important clinical pathological feature,not only participates in various biological processes such as development,growth,invasion,and metastasis of pancreatic cancer,but also is closely associated with poor prognosis in pancreatic cancer. This article systematically reviews the latest research advancements in the field of PNI in pancreatic cancer,providing a multidimensional analysis of its anatomical basis,cytokine regulatory networks,metabolic reprogramming mechanisms,vesicle-mediated molecular transport,immune-neural interactions,pain-inducing pathomechanism,quantitative assessment frameworks,experimental model construction,cutting-edge technological applications,and innovations in surgical strategies. In the surgical domain,precision techniques combining targeted nerve plexus resection with molecular-targeted probes have significantly improved the R0 resection rate,while surgical navigation strategies based on single-cell spatial transcriptomics offer novel insights for optimizing therapeutic paradigms. Future research should prioritize the discovery of PNI-specific molecular targets,multidimensional exploration of the neural-immune-metabolic axis,and addressing the challenges of integrating interdisciplinary technologies into clinical translation.
神经周围浸润（PNI）作为胰腺癌的重要临床病理学特征，不仅参与肿瘤的发展、生长、侵袭和转移等各种生物学过程，而且还与胰腺癌的不良预后密切相关。本文综述了胰腺癌PNI领域的研究进展，从多维度解析其解剖学基础、相关细胞因子调控网络、代谢重编程机制、囊泡介导的分子传递、免疫-神经交互作用、疼痛的病理学机制、定量化评估体系、实验模型构建与前沿技术应用，以及外科治疗策略的革新。在外科领域，神经丛定向切除联合分子靶向探针的精准术式提高了R0切除率，而基于单细胞空间转录组的手术导航策略为优化治疗范式提供了新思路。未来研究需聚焦于PNI特异性靶点的发现、神经-免疫-代谢轴的多维度解析，以及跨学科技术融合在临床转化中的挑战。.