Department of Surgery, City of Hope National Medical Center, Duarte, California.
Department of Surgery, City of Hope National Medical Center, Duarte, California.
Am J Pathol. 2019 Jan;189(1):44-57. doi: 10.1016/j.ajpath.2018.09.009.
Pancreatic ductal adenocarcinoma (PDAC) is increasing in incidence and is projected to become the second leading cause of cancer death in the United States. Despite significant advances in understanding the disease, there has been minimal increase in PDAC patient survival. PDAC tumors are unique in the fact that there is significant desmoplasia. This generates a large stromal compartment composed of immune cells, inflammatory cells, growth factors, extracellular matrix, and fibroblasts, comprising the tumor microenvironment (TME), which may represent anywhere from 15% to 85% of the tumor. It has become evident that the TME, including both the stroma and extracellular component, plays an important role in tumor progression and chemoresistance of PDAC. This review will discuss the multiple components of the TME, their specific impact on tumorigenesis, and the multiple therapeutic targets.
胰腺导管腺癌（PDAC）的发病率正在上升，预计将成为美国第二大致癌死亡原因。尽管人们对这种疾病有了更深入的了解，但 PDAC 患者的生存率却没有明显提高。PDAC 肿瘤的独特之处在于存在显著的纤维变性。这会产生一个由免疫细胞、炎症细胞、生长因子、细胞外基质和成纤维细胞组成的大型基质隔室，构成肿瘤微环境（TME），它可能占肿瘤的 15%至 85%。已经很明显，TME 包括基质和细胞外成分，在 PDAC 的肿瘤发生和化疗耐药性中发挥着重要作用。这篇综述将讨论 TME 的多个组成部分，它们对肿瘤发生的具体影响，以及多个治疗靶点。
