Tiffon Céline
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Biomedicines. 2020 Jun 26;8(6):178. doi: 10.3390/biomedicines8060178.
Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant tumor with a dismal prognosis, largely due to its late presentation. Methods for early detection, the development of reliable screening tools, and the identification of sensitive and specific biomarkers have remained essential research priorities to improve early patient management and outcomes. The pancreas and salivary glands share histological and functional similarities, and the salivary glands have a demonstrated a role in oral and systemic health. This review focuses on the similarities and differences between the pancreas and salivary glands and how these can inform our understanding of PDAC genesis and early diagnosis. In particular, chemical exposure, which alters salivary gland gene transcription and morphogenesis, may not only directly impact salivary gland regulation but alter pancreatic function via the systemic secretion of growth hormones. Diabetes and obesity are associated with an increased risk of pancreatic cancer, and a link between chemical exposure and the development of diabetes, obesity, and consequently PDAC genesis is proposed. Possible mechanisms include altering salivary or pancreatic morphology and organ function, disrupting endocrine signaling, or altering pro-inflammatory homeostasis. Finally, saliva contains putative specific biomarkers that show promise as non-invasive diagnostic tools for PDAC.
胰腺导管腺癌（PDAC）是一种恶性程度很高的肿瘤，预后很差，这主要是由于其发现时往往已处于晚期。早期检测方法、可靠筛查工具的开发以及敏感且特异的生物标志物的识别，仍然是改善患者早期管理和预后的重要研究重点。胰腺和唾液腺在组织学和功能上有相似之处，并且唾液腺在口腔和全身健康方面已显示出作用。本综述重点关注胰腺和唾液腺之间的异同，以及这些异同如何增进我们对PDAC发生和早期诊断的理解。特别是，化学暴露会改变唾液腺基因转录和形态发生，这不仅可能直接影响唾液腺调节，还可能通过生长激素的全身分泌改变胰腺功能。糖尿病和肥胖与胰腺癌风险增加相关，并且有人提出化学暴露与糖尿病、肥胖的发生以及由此导致的PDAC发生之间存在联系。可能的机制包括改变唾液腺或胰腺的形态和器官功能、破坏内分泌信号传导或改变促炎内环境稳定。最后，唾液中含有一些有望成为PDAC非侵入性诊断工具的特定生物标志物。
