关键词: 胆囊癌, 周围神经侵犯, 多模式诊治

Abstract: Surgical treatment is the most effective treatment for gallbladder cancer (GBC), but advanced GBC has a high rate of tumor recurrence and poor prognosis after surgery. Perineural invasion (PNI) is a critical event in the early stages of invasive GBC progression and an important unfavorable factor affecting the outcome of surgical treatment for advanced GBC. Improving the accuracy of preoperative diagnosis of PNI to formulate and implement individualized surgical plans, achieving the thoroughness of clearing the risk area of hidden residual cancer cells, and adopting postoperative multimodal treatment strategies such as adjuvant radiotherapy and chemotherapy are of great significance in reducing the risk of tumor recurrence associated with PNI and improving the overall outcome of surgical treatment for advanced GBC. The establishment of intelligent diagnostic models based on PNI biomarkers, multimodal data (including anatomic, functional and metabolic data) from high-field intensity MRI, radiomics data, and artificial intelligence technology, as well as the conduct of clinical studies (such as rational tumor resection and regional clearance scope based on intraoperative fluorescent tracing and perioperative radiotherapy combined with targeted or immunotherapy) will provide evidence for the construction of an individualized multi-modal diagnostic and treatment plan for advanced GBC.

Key words: gallbladder cancer, perineural invasion, multimodal therapy