Ansari Daniel, Friess Helmut, Bauden Monika, Samnegård Johan, Andersson Roland
Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
Department of Surgery, Technical University of Munich, Munich, Germany.
Oncotarget. 2018 Jan 6;9(5):6644-6651. doi: 10.18632/oncotarget.24019. eCollection 2018 Jan 19.
Pancreatic cancer is known for its propensity to metastasize. Recent studies have challenged the commonly held belief that pancreatic cancer is a stepwise process, where tumor cells disseminate late in primary tumor development. Instead it has been suggested that pancreatic tumor cells may disseminate early and develop independently and in parallel to the primary tumor. Circulating tumor cells can be found in most patients with pancreatic cancer, even in those with localized stage. Also, recent phylogenetic analyses have revealed evidence for a branched evolution where metastatic lineages can develop early in tumor development. In this Review, we discuss current models of pancreatic cancer progression and the importance of the tumor microenvironment, in order to better understand the recalcitrant nature of this disease.
胰腺癌以其易于转移而闻名。最近的研究对胰腺癌是一个逐步发展的过程这一普遍观点提出了挑战，该观点认为肿瘤细胞在原发性肿瘤发展的后期才会扩散。相反，有人提出胰腺肿瘤细胞可能在早期就发生扩散，并与原发性肿瘤独立且并行发展。在大多数胰腺癌患者中都能发现循环肿瘤细胞，即使是那些处于局限性阶段的患者。此外，最近的系统发育分析揭示了分支进化的证据，即转移谱系可以在肿瘤发展的早期就形成。在本综述中，我们讨论了胰腺癌进展的当前模型以及肿瘤微环境的重要性，以便更好地理解这种疾病难以治愈的本质。
