摘要
背景:胰腺导管腺癌(PDAC)是破坏性的。由于其沉默性质,一旦达到高级,经常不能手术的阶段,该疾病通常被诊断出来。迄今为止,我们没有促进早期诊断的生物标志物,留下足够的时间进行治疗性治疗,有效降低了该癌症实体的非常高的死亡率。因此,PDAC患者的预期寿命较低(即5年生存率≤6%)。包括PDAC肿瘤基质特征和特征的新数据可能会更好地解释其侵袭性,相对持久的无痛扩张以及为何化疗如此频繁失败。典型的肿瘤诱导的基质细胞增生症的特征是与癌症相关的成纤维细胞(CAF),免疫监视减少,癌症相关的神经重塑和非常低的血管密度。这种基质微环境产生缺氧,营养缺乏,免疫抑制和化学耐药性。这些因素的结合导致了一种恶性疾病,从大肿瘤块的长期,无症状发展开始,其后是高百分比的不可手术状态的延迟诊断,对所有保守治疗方案(包括辐射)表现出差的反应,其结束转移导致快速的致命结果。 目的:在本文中,我们回顾了PDAC组织的遗传,细胞,免疫学,纳米医学和基质特征的联系,并讨论与肿瘤进展速率相关和/或之前的代谢异常。 结论:对基础机制的更全面的了解可以改善患有这种破坏性癌症的患者的诊断和治疗管理。
关键词: 胰腺导管腺癌,基质pdac细胞相互作用的新见解,神经重塑方面,免疫学方面,代谢方面,遗传方面,纳米医学方面。
Current Medicinal Chemistry
Title:New Diagnostic and Therapeutic Aspects of Pancreatic Ductal Adenocarcinoma
Volume: 24 Issue: 28
关键词: 胰腺导管腺癌,基质pdac细胞相互作用的新见解,神经重塑方面,免疫学方面,代谢方面,遗传方面,纳米医学方面。
摘要: Background: Pancreatic ductal adenocarcinoma (PDAC) is devastating. Because of its silent nature, the disease is often only diagnosed once it has reached an advanced, frequently inoperable stage. To date, we have no biomarkers that facilitate earlier diagnosis, leaving sufficient time for curative therapy that effectively lowers the very high mortality rate of this cancer entity. Because of this, the life expectancy of patients with PDAC is low (i.e. ≤ 6% five-year survival rates). New data, including particular genetic signatures and features of the stromal architecture of PDAC tumors, may better explain their aggressiveness, their relatively long-lasting painless expansion, and why chemotherapy so frequently fails. The typical tumor-induced stromal desmoplasia is characterized by cancer-associated fibroblasts (CAFs), decreased immune surveillance, cancer-associated neural remodeling, and a very low vascular density. This stromal microenvironment generates hypoxia, nutrient deficiency, immune suppression, and chemoresistance. The combination of factors results in a vicious disease that begins with the long-lasting, asymptomatic development of a large tumor mass, followed by a delayed diagnosis with a high percentage of inoperable states, exhibiting a poor response to all conservative therapeutic options, including radiation, and which ends with metastasis resulting in a rapid fatal outcome.
Objective: In this article, we review coherences on genetic, cellular, immunological, Nano medical and stromal characteristics of PDAC tissue, and discuss metabolic abnormalities associated with and/or preceding the tumor progression rate.
Conclusion: A more comprehensive understanding of the underlying mechanisms can improve the diagnostic and therapeutic management of patients suffering from this devastating type of cancer.
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Cite this article as:
New Diagnostic and Therapeutic Aspects of Pancreatic Ductal Adenocarcinoma, Current Medicinal Chemistry 2017; 24 (28) . https://dx.doi.org/10.2174/0929867324666170510150124
DOI https://dx.doi.org/10.2174/0929867324666170510150124 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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