Yachida Shinichi, Iacobuzio-Donahue Christine A
The Johns Hopkins Medical Institutions, The Sol Goldman Pancreatic Cancer Research Center, Baltimore, Maryland 21231, USA.
Arch Pathol Lab Med. 2009 Mar;133(3):413-22. doi: 10.5858/133.3.413.
Metastatic disease is the most critical determinant of resectability of pancreatic cancer and accounts for the poor outcome of patients with this disease. Thus, a better understanding of metastatic pancreatic cancer will afford new opportunities for therapeutic intervention.
To summarize and discuss the current understanding of the clinical and molecular features of metastatic pancreatic cancer.
Published literature on advanced stage pancreatic cancer, pancreatic cancer metastasis, and autopsy findings in patients with pancreatic cancer.
In the clinical setting, it can be difficult to distinguish a metastatic pancreatic carcinoma from primary neoplasms in the liver, lung, or ovary. However, immunolabeling for DPC4 protein as part of a diagnostic panel is useful for making this distinction. Emerging data from a variety of investigators now indicate that overexpression of EphA2, loss of DPC4 and MKK4, and aberrant activation of the Hedgehog signaling pathway are associated with metastatic propensity of pancreatic cancers, providing novel therapeutic targets for the most lethal stage of this disease.
转移性疾病是胰腺癌可切除性的最关键决定因素，也是该疾病患者预后不良的原因。因此，更好地了解转移性胰腺癌将为治疗干预提供新的机会。
总结并讨论目前对转移性胰腺癌临床和分子特征的认识。
已发表的关于晚期胰腺癌、胰腺癌转移以及胰腺癌患者尸检结果的文献。
在临床环境中，很难将转移性胰腺癌与肝、肺或卵巢的原发性肿瘤区分开来。然而，作为诊断指标之一的DPC4蛋白免疫标记有助于进行这种区分。来自众多研究者的新数据表明，EphA2过表达、DPC4和MKK4缺失以及Hedgehog信号通路的异常激活与胰腺癌的转移倾向相关，为该疾病最致命阶段提供了新的治疗靶点。
