Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Department of Medical Biophysics, University of Toronto, Toronto, Canada.
Gut. 2017 Dec;66(12):2170-2178. doi: 10.1136/gutjnl-2016-313317. Epub 2017 Oct 9.
A diagnosis of pancreatic ductal adenocarcinoma (PDA) is often fatal. PDA is widely recognised as one of the 'incurable cancers' because therapies against this tumour type are generally ineffective. The fatal nature of this tumour is due to its aggressive clinical course. Pancreatic cancer commonly presents at the metastatic stage; even in cases where tumours are localised to the pancreas at diagnosis, metastatic seeds have often been invariably been spawned off, frustrating surgical attempts to cure the cancer. The key principles of pancreatic cancer mutational development were outlined nearly two decades ago using the genetics of precursor lesions to position the various stages of tumour progression. Since then, there has been a cavalcade of new data. How these recent studies impact the classical perceptions of pancreatic cancer development is a work in progress. Given that significant improvements in patient outcomes are not in sight for this disease, it is likely that broadening the current perspectives and acquiring deeper biological insights into the morphogenetic route of tumour development will be needed to foster new strategies for more effective cancer control.
胰腺导管腺癌 (PDA) 的诊断通常是致命的。PDA 被广泛认为是“无法治愈的癌症”之一，因为针对这种肿瘤类型的治疗通常无效。这种肿瘤的致命性质是由于其侵袭性的临床过程。胰腺癌通常在转移阶段出现；即使在诊断时肿瘤局限于胰腺的情况下，转移性种子也经常已经产生，这挫败了手术治愈癌症的尝试。近二十年前，使用前体病变的遗传学来定位肿瘤进展的各个阶段，概述了胰腺癌突变发展的关键原则。自那时以来，已经有大量新的数据。这些最近的研究如何影响对胰腺癌发展的经典看法是一个正在进行的工作。鉴于这种疾病的患者预后没有明显改善，很可能需要拓宽当前的观点，并深入了解肿瘤发展的形态发生途径的生物学见解，以培养更有效的癌症控制的新策略。
