藤黄酸在胰腺癌中的实验机制研究与临床应用进展

Research Advances on the Experimental Mechanisms and Clinical Applications of Gambogic Acid in Pancreatic Cancer

摘要: 藤黄酸(GA)是一种具有多戊二烯化氧杂蒽酮结构的天然化合物，来源于东南亚发现的莫氏藤黄树，表现出广泛的生物活性，通过调控细胞凋亡、调控细胞周期、调控自噬、调控细胞焦亡和铁死亡以及抑制血管生成从而发挥抗肿瘤、抗菌和抗增殖的生物学作用，在抗肿瘤领域得到广泛的研究。胰腺癌(PC)是一种高度恶性的胃肠道肿瘤，其发病率逐年上升，由于患者在早期阶段无明显临床症状，因此早期诊断困难，该病在早期往往被误诊或延迟诊断。而且由于胰腺癌细胞具有高度的侵袭性，容易通过血液和淋巴系统发生远距离转移，所以患者在诊断时已经有肝、腹膜等器官的转移，导致治疗选择受到极大限制。现有的治疗方法包括手术、化疗、放疗等，但由于该肿瘤对常规治疗的反应较差，且耐药性强，导致其治疗效果有限。即使经过治疗，患者的预后通常较差，5年生存率仍低于5%。因此，胰腺癌被认为是最具挑战性的恶性肿瘤之一，因此急需寻找新的早期诊断方法和更有效的治疗策略。当前的研究表明，藤黄酸对胰腺癌展现出很好的抑制率，联合用药可增强治疗效果。本文通过对藤黄酸在胰腺癌中的实验机制研究与当前的临床应用进行综述，为其在未来投入到临床治疗胰腺癌中提供参考。

Abstract: Gambogic acid (GA) is a natural compound with a polyprenylated benzophenone structure, derived from the Garcinia morella tree, which is found in Southeast Asia. It exhibits a broad range of biological activities, including regulation of apoptosis, cell cycle, autophagy, pyroptosis, and ferroptosis, as well as inhibition of angiogenesis. These properties contribute to its anti-tumor, anti-bacterial, and anti-proliferative effects, making it a subject of extensive research in cancer treatment. Pancreatic cancer (PC) is a highly malignant gastrointestinal tumor with an increasing incidence rate. Due to the lack of obvious clinical symptoms in the early stages, early diagnosis is challenging, and the disease is often misdiagnosed or diagnosed late. Furthermore, pancreatic cancer cells are highly invasive, easily spreading through the bloodstream and lymphatic system, leading to distant metastasis, such as in the liver and peritoneum, by the time of diagnosis. This significantly limits treatment options. Current therapies, including surgery, chemotherapy, and radiotherapy, have limited efficacy because the tumor exhibits poor response to conventional treatments and develops resistance rapidly. Even with treatment, the prognosis remains poor, with a five-year survival rate of less than 5%. As such, pancreatic cancer remains one of the most challenging malignancies, underscoring the urgent need for new diagnostic methods and more effective treatment strategies. Recent studies suggest that gambogic acid has shown promising anti-cancer effects against pancreatic cancer, with combination therapies enhancing its therapeutic potential. This review summarizes the experimental mechanisms of gambogic acid in pancreatic cancer and its current clinical applications, providing valuable insights for its future use in clinical treatment of pancreatic cancer.