Tuveson D A, Hingorani S R
Department of Medicine, Abramson Family Cancer Research Institute, Abramson Cancer Center at the University of Pennsylvania, Philadelphia, 19104, USA.
Cold Spring Harb Symp Quant Biol. 2005;70:65-72. doi: 10.1101/sqb.2005.70.040.
Pancreatic ductal adenocarcinoma (PDA) eludes early detection and resists current therapies, earning its distinction as the most lethal malignancy by organ site in the western world. This dire reality prompted extensive yet generally disappointing efforts to generate transgenic mouse models of this malignancy. Recently, mutant mice that develop pancreatic intraepithelial neoplasms (PanIN), the presumed preinvasive stage of PDA, were produced by conditionally expressing an endogenous oncogenic Kras allele in the developing murine pancreas. Mice with PanIN demonstrated promise in the pursuit of biomarkers of early pancreatic cancer, and, importantly, such mice eventually developed and succumbed to PDA after a long latency, establishing PanINs as true precursors to the invasive disease. Furthermore, the incorporation of conditional mutations in tumor suppressor alleles known to be altered in human PDA synergized with oncogenic Kras to produce advanced PDA with a short latency, recapitulating central pathophysiological events in human PDA. These models facilitate a variety of biological and clinical investigations such as explorations of the cellular origins of PDA and the development of treatment strategies for advanced PanIN and PDA. In addition, lessons from modeling PDA may be applicable to other tumor types and illuminate general principles of carcinogenesis.
胰腺导管腺癌(PDA)难以早期发现且对当前治疗具有抗性,在西方世界成为按器官部位划分的最致命恶性肿瘤。这一严峻现实促使人们为构建这种恶性肿瘤的转基因小鼠模型付出了广泛但总体令人失望的努力。最近,通过在发育中的小鼠胰腺中条件性表达内源性致癌性Kras等位基因,培育出了会发展为胰腺上皮内瘤变(PanIN)的突变小鼠,PanIN被认为是PDA的侵袭前阶段。患有PanIN的小鼠在寻找早期胰腺癌生物标志物方面展现出了前景,而且重要的是,这类小鼠最终在长时间潜伏期后发展并死于PDA,确立了PanIN作为侵袭性疾病真正前体的地位。此外,在已知在人类PDA中发生改变的肿瘤抑制等位基因中引入条件性突变,与致癌性Kras协同作用,可在短时间潜伏期内产生晚期PDA,重现人类PDA的核心病理生理事件。这些模型有助于开展各种生物学和临床研究,例如探究PDA的细胞起源以及开发针对晚期PanIN和PDA的治疗策略。此外,PDA建模所获得经验教训可能适用于其他肿瘤类型,并阐明癌症发生的一般原则。