Høgdall Dan, Lewinska Monika, Andersen Jesper B
Biotech Research and Innovation Centre (BRIC), Department of Health and Medical Sciences, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen N, Denmark; Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; These authors contributed equally.
Biotech Research and Innovation Centre (BRIC), Department of Health and Medical Sciences, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen N, Denmark; These authors contributed equally.
Trends Cancer. 2018 Mar;4(3):239-255. doi: 10.1016/j.trecan.2018.01.007. Epub 2018 Feb 21.
Cholangiocarcinoma (CCA) is a dismal disease which often is diagnosed at a late stage where the tumor is locally advanced, metastatic, and, as a result, is associated with low resectability. The heterogeneity of this cancer type is a major reason why the majority of patients fail to respond to therapy, and surgery remains their only curative option. Among patients who undergo surgical intervention, such tumors typically recur in 50% of cases within 1year. Thus, CCA is among the most aggressive and chemoresistant malignancies. CCA is characterized by marked tumor reactive stroma, a fibrogenic connective tissue which surrounds and infiltrates the tumor epithelium. This desmoplastic environment presents a clinical challenge, limiting drug delivery and supporting the growth of the tumor mass. In this review we attempt to highlight key pathways involved in cell to cell communication between the tumor epithelium and stroma, the immune components, and opportunities for novel strategies to improve patient outcome.
胆管癌（CCA）是一种预后不佳的疾病，通常在肿瘤局部进展、发生转移的晚期阶段才被诊断出来，因此可切除性较低。这种癌症类型的异质性是大多数患者对治疗无反应的主要原因，手术仍然是唯一的治愈选择。在接受手术干预的患者中，这类肿瘤通常在1年内有50%的病例复发。因此，CCA是最具侵袭性和化疗耐药性的恶性肿瘤之一。CCA的特征是有明显的肿瘤反应性基质，即一种围绕并浸润肿瘤上皮的纤维生成性结缔组织。这种促结缔组织增生环境带来了临床挑战，限制了药物递送并支持肿瘤块的生长。在本综述中，我们试图强调肿瘤上皮与基质、免疫成分之间细胞间通讯所涉及的关键途径，以及改善患者预后的新策略的机会。
