The monitoring of pancreatic ductal adenocarcinoma (PDAC) in high-risk populations is essential. Cathepsin E (CTSE) is specifically and highly expressed in PDAC and pancreatic intraepithelial neoplasias (PanINs), and its expression gradually increases along with disease progression. In this study, we first established an in situ 7,12-dimethyl-1,2-benzanthracene (DMBA)-induced rat model for PanINs and PDAC and then confirmed that tumorigenesis properties in this model were consistent with those of human PDAC in that CTSE expression gradually increased with tumor development using histology and immunohistochemistry. Then, using in vivo imaging of heterotopically implanted tumors generated from CTSE- overexpressing cells (PANC-1-CTSE) in nude mice and in vitro imaging of PanINs and PDAC in DMBA-induced rats, the specificity of the synthesized CTSE-activatable probe was verified. Quantitative determination identified that the fluorescence signal ratio of pancreatic tumor to normal pancreas gradually increased in association with progressive pathological grades, with the exception of no significant difference between PanIN-II and PanIN-III grades. Finally, we monitored pancreatic carcinogenesis in vivo using confocal laser endomicroscopy (CLE) in combination with the CTSE-activatable probe. A prospective double-blind control study was performed to evaluate the accuracy of this method in diagnosing PDAC and PanINs of all grades (>82.7%). This allowed us to establish effective diagnostic criteria for CLE in PDAC and PanINs to facilitate the monitoring of PDAC in high-risk populations.
监测高危人群中的胰腺导管腺癌(
PDAC)至关重要。胰
蛋白酶 E(CT
SE)在
PDAC 和胰腺上皮内瘤(
PANINs)中特异性高表达,其表达随疾病进展而逐渐增加。在这项研究中,我们首先建立了一个原位 7,12-
二甲基-1,2-苯并蒽 (
DMBA) 诱导的
PANINs 和
PDAC 大鼠模型,然后利用组织学和免疫组化方法证实了该模型的肿瘤发生特性与人类
PDAC 一致,即 CT
SE 的表达随着肿瘤的发展而逐渐增加。然后,利用 CT
SE 过表达细胞(
PANC-1-CT
SE)在裸鼠体内异位植入肿瘤的成像以及
DMBA 诱导的大鼠
PANINs 和
PDAC 的体外成像,验证了合成的 CT
SE 可激活探针的特异性。定量测定发现,胰腺肿瘤与正常胰腺的荧光信号比随着病理分级的进展而逐渐增加,但
PANIN-II 级与
PANIN-III 级之间无明显差异。最后,我们使用共焦激光内窥镜(CLE)结合 CT
SE 可激活探针监测体内胰腺癌的发生。我们进行了一项前瞻性双盲对照研究,以评估该方法在诊断
PDAC 和各等级
PANINs 方面的准确性(>82.7%)。这使我们能够为
PDAC 和
PANINs 中的 CLE 建立有效的诊断标准,以促进对高危人群中
PDAC 的监测。