Gel-HAC通过增强浆膜稳定性提高结直肠癌pT4诊断准确率的作用及机制研究

准确的病理分期是结直肠癌精准治疗的基础。我们发现：肿瘤浆膜浸润（pT4）的普遍低估引起生存差异，且影响治疗决策。我们前期设计了能够有效贴合并粘附于肠道浆膜，且在病理制片全程起到浆膜保护作用的水凝胶Gel-HAC；但其具体作用机制及对pT4诊断准确性的提升效果尚未阐明。我们假设：Gel-HAC可以通过与间皮细胞表面的透明质酸形成“缝合-缝合”分子拓扑结构，对浆膜面进行有效的粘附与包裹，从而增强稳定性。基于此，研究将从以下几个方面进行：1.探究Gel-HAC的基本物理特性及在制片全程中对浆膜的保护效果；2.阐明Gel-HAC稳定肠道浆膜的具体作用机制；3.通过前瞻性实验，探索Gel-HAC对结直肠癌pT4诊断准确率的提升效果。研究成果将为结直肠癌精准病理诊断提供新的思路与技术，同时也为肠道浆膜保护材料的制备与应用提供直接的理论依据。

Accurate pathological staging is the basis of precision treatment of colorectal cancer (CRC). We found the underestimation of tumor serosal infiltration (PT4) influenced survival and treatment decisions. We previously designed the hydrogel Gel-HAC, which can be effectively attached and adhered to the intestinal serosal and play a protective role in the whole process of HE slides preparation. However, the specific mechanism of its action and the effect of improving pT4 diagnostic accuracy have not been clarified. We hypothesized that Gel-HAC could effectively adhere and wrap the serosal surface by forming a "stich-stich" molecular topology with hyaluronic acid on the surface of mesothelial cells, thus enhancing the stability. Based on this, the research will be carried out from the following aspects: First, to explore the basic physical properties of Gel-HAC and its protective effect on the serous film during the whole production process; Second, to clarify the specific mechanism of Gel-HAC stabilizing intestinal serosal membrane; Third, prospective experiments were conducted to explore the improvement effect of Gel-HAC on the diagnostic accuracy of pT4 CRC. The research results will provide new ideas and techniques for accurate pathological diagnosis of CRC, and also provide a direct theoretical basis for the preparation and application of intestinal serosal protective biomaterials.