消化系统肿瘤具有高发病率、高死亡率及发病年轻化等特点，是严重威胁人类健康的重大疾病。泛凋亡是一种由泛凋亡小体精密调控的新型炎症程序性细胞死亡方式，整合了凋亡、焦亡与坏死性凋亡的关键特征。在消化系统肿瘤中，ZDNA结合蛋白1（ZBP1）、黑色素瘤缺乏因子2（AIM2）等分子传感器介导的泛凋亡，不仅参与重塑肿瘤免疫微环境，还与致癌信号通路存在广泛串扰，影响肿瘤细胞命运。研究表明，靶向诱导泛凋亡可提高免疫检查点抑制剂（ICIs）疗效、逆转结直肠癌与胃癌等对奥沙利铂、氟尿嘧啶的化疗耐药；基于泛凋亡相关基因或lncRNA构建的预后模型，亦在肝细胞癌、胃癌等肿瘤的预后评估与治疗应答预测中展现出良好价值。系统梳理泛凋亡的核心分子机制，并结合肝细胞癌、结直肠癌、胃癌、食管癌及胰腺癌等常见消化系统肿瘤，综述其在综合治疗与预后预测中的转化应用进展，以期为开发靶向泛凋亡的新型抗肿瘤策略提供依据。

Digestive system tumors have the characteristics of high incidence, high mortality, and younger onset, and are major diseases that seriously threaten human health. PANoptosis is a novel inflammatory programmed cell death mode precisely regulated by PANoptosome, integrating the key features of apoptosis, pyroptosis, and necroptosis. In digestive system tumors, the PANoptosis mediated by molecular sensors such as Z-DNA binding protein 1 (ZBP1) and absent in melanoma 2 (AIM2) not only participates in reshaping the tumor immune microenvironment but also has extensive crosstalk with oncogenic signaling pathways, affecting the fate of tumor cells. Studies have shown that targeting the induction of PANoptosis can improve the efficacy of immune checkpoint inhibitors (ICIs), reverse the chemotherapy resistance of colorectal cancer and gastric cancer to oxaliplatin and fluorouracil; prognostic models based on PANoptosis-related genes or lncRNAs have also shown good value in the prognosis assessment and treatment response prediction of liver cell carcinoma, gastric cancer, etc. The core molecular mechanisms of PANoptosis are systematically reviewed, and combined with common gastrointestinal cancers such as hepatocellular carcinoma, colorectal cancer, gastric cancer, esophageal cancer, and pancreatic cancer, the progress of its transformation application in comprehensive treatment and prognosis prediction is summarized, with the aim of providing a basis for developing new anti-tumor strategies targeting PANoptosis.

R735;R979.1

国家自然科学基金资助项目（82204981）；河南省中医院博士科研基金（2022BSJJ07）；河南省中医院博士科研基金（2023BSJJ02）；国家中医临床研究基地科研专项（2021JDZX2002）