Karamitopoulou Eva
Clinical Pathology Division, Institute of Pathology, University of Bern , Bern , Switzerland ; Translational Research Unit, Institute of Pathology, University of Bern , Bern , Switzerland.
Front Oncol. 2013 Sep 17;3:221. doi: 10.3389/fonc.2013.00221.
Pancreatic ductal adenocarcinoma (PDAC) ranks as the fourth commonest cause of cancer death while its incidence is increasing worldwide. For all stages, survival at 5 years is<5%. The lethal nature of pancreatic cancer is attributed to its high metastatic potential to the lymphatic system and distant organs. Lack of effective therapeutic options contributes to the high mortality rates of PDAC. Recent evidence suggests that epithelial-mesenchymal transition (EMT) plays an important role to the disease progression and development of drug resistance in PDAC. Tumor budding is thought to reflect the process of EMT which allows neoplastic epithelial cells to acquire a mesenchymal phenotype thus increasing their capacity for migration and invasion and help them become resistant to apoptotic signals. In a recent study by our own group the presence and prognostic significance of tumor budding in PDAC were investigated and an association between high-grade budding and aggressive clinicopathological features of the tumors as well as worse outcome of the patients was found. The identification of EMT phenotypic targets may help identifying new molecules so that future therapeutic strategies directed specifically against them could potentially have an impact on drug resistance and invasiveness and hence improve the prognosis of PDAC patients. The aim of this short review is to present an insight on the morphological and molecular aspects of EMT and on the factors that are involved in the induction of EMT in PDAC.
胰腺导管腺癌（PDAC）是癌症死亡的第四大常见原因，且其发病率在全球范围内呈上升趋势。对于所有阶段而言，5年生存率<5%。胰腺癌的致命性归因于其向淋巴系统和远处器官转移的高潜力。缺乏有效的治疗选择导致了PDAC的高死亡率。最近的证据表明，上皮-间质转化（EMT）在PDAC的疾病进展和耐药性发展中起重要作用。肿瘤芽生被认为反映了EMT过程，该过程使肿瘤上皮细胞获得间质表型，从而增加其迁移和侵袭能力，并帮助它们对凋亡信号产生抗性。在我们自己团队最近的一项研究中，对PDAC中肿瘤芽生的存在及其预后意义进行了研究，发现高级别芽生与肿瘤侵袭性临床病理特征以及患者较差的预后之间存在关联。EMT表型靶点的鉴定可能有助于识别新分子，从而使未来针对它们的治疗策略可能对耐药性和侵袭性产生影响，进而改善PDAC患者的预后。本简短综述的目的是深入了解EMT的形态学和分子方面，以及PDAC中诱导EMT的相关因素。
