Nielsen Michael Friberg Bruun, Mortensen Michael Bau, Detlefsen Sönke
Michael Friberg Bruun Nielsen, Sönke Detlefsen, Department of Pathology, Odense University Hospital, University of Southern Denmark, 5000 Odense, Denmark.
World J Gastroenterol. 2016 Mar 7;22(9):2678-700. doi: 10.3748/wjg.v22.i9.2678.
Pancreatic cancer (PC) is the most aggressive type of common cancers, and in 2014, nearly 40000 patients died from the disease in the United States. Pancreatic ductal adenocarcinoma, which accounts for the majority of PC cases, is characterized by an intense stromal desmoplastic reaction surrounding the cancer cells. Cancer-associated fibroblasts (CAFs) are the main effector cells in the desmoplastic reaction, and pancreatic stellate cells are the most important source of CAFs. However, other important components of the PC stroma are inflammatory cells and endothelial cells. The aim of this review is to describe the complex interplay between PC cells and the cellular and non-cellular components of the tumour stroma. Published data have indicated that the desmoplastic stroma protects PC cells against chemotherapy and radiation therapy and that it might promote the proliferation and migration of PC cells. However, in animal studies, experimental depletion of the desmoplastic stroma and CAFs has led to more aggressive cancers. Hence, the precise role of the tumour stroma in PC remains to be elucidated. However, it is likely that a context-dependent therapeutic modification, rather than pure depletion, of the PC stroma holds potential for the development of new treatment strategies for PC patients.
胰腺癌（PC）是常见癌症中侵袭性最强的类型，2014年在美国，近40000名患者死于该疾病。占PC病例大多数的胰腺导管腺癌的特征是癌细胞周围有强烈的间质促纤维增生反应。癌症相关成纤维细胞（CAF）是促纤维增生反应中的主要效应细胞，胰腺星状细胞是CAF的最重要来源。然而，PC间质的其他重要成分是炎症细胞和内皮细胞。本综述的目的是描述PC细胞与肿瘤间质的细胞和非细胞成分之间复杂的相互作用。已发表的数据表明，促纤维增生性间质可保护PC细胞免受化疗和放疗，并且可能促进PC细胞的增殖和迁移。然而，在动物研究中，促纤维增生性间质和CAF的实验性清除导致了更具侵袭性的癌症。因此，肿瘤间质在PC中的精确作用仍有待阐明。然而，对PC间质进行依赖于具体情况的治疗性修饰，而非单纯清除，可能为PC患者开发新的治疗策略带来潜力。
