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| 1 | Key players in pancreatic cancer-stroma interaction: cancer-associated fibroblasts, endothelial and inflammatory cells显示文摘Pancreatic cancer(PC) is the most aggressive type of common cancers, and in 2014, nearly 40000 patients died from the disease in the United States. Pancreatic ductal adenocarcinoma, which accounts for the majority of PC cases, is characterized by an intense stromal desmoplastic reaction surrounding the cancer cells. Cancer-associated fibroblasts(CAFs) are the main effector cells in the desmoplastic reaction, and pancreatic stellate cells are the most important source of CAFs. However, other important components of the PC stroma are inflammatory cells and endothelial cells. The aim of this review is to describe the complex interplay between PC cells and the cellular and noncellular components of the tumour stroma. Published data have indicated that the desmoplastic stroma protects PC cells against chemotherapy and radiation therapy and that it might promote the proliferation and migration of PC cells. However, in animal studies, experimental depletion of the desmoplastic stroma and CAFs has led to more aggressive cancers. Hence, the precise role of the tumour stroma in PC remains to be elucidated. However, it is likely that a contextdependent therapeutic modification, rather than pure depletion, of the PC stroma holds potential for the development of new treatment strategies for PC patients. | Michael Friberg Bruun Nielsen Michael Bau Mortensen Sonke Detlefsen | 2016 | World Journal of Gastroenterology2016，22，9： | 20 |
| 2 | Perioperative treatment options in resectable pancreatic cancer-how to improve long-term survival显示文摘Surgery remains the only chance of cure for pancreatic cancer, but only 15%-25% of patients present with resectable disease at the time of primary diagnosis. Important goals in clinical research must therefore be to allow early detection with suitable diagnostic procedures, to further broaden operation techniques and to determine the most effective perioperative treatment of either chemotherapy and/or radiation therapy. More extensive operations involving extended pancreatectomy, portal vein resection and pancreatic resection in resectable pancreatic cancer with limited liver metastasis, performed in specialized centers seem to be the surgical procedures with a possible impact on survival. After many years of stagnation in pharmacological clinical research on advanced pancreatic ductal adenocarcinomas(PDAC)- since the approval of gemcitabine in 1997- more effective cytotoxic substances(nab-paclitaxel) and combinations(FOLFIRINOX) are now available for perioperative treatment. Additionally, therapies with a broader mechanism of action are emerging(stroma depletion, immunotherapy, antiinflammation), raising hopes for more effective adjuvant and neoadjuvant treatment concepts, especially in the context of 'borderline resectability'. Only multidisciplinary approaches including radiology, surgery, medical and radiation oncology as the backbones of the treatment of potentially resectable PDAC may be able to further improve the rate of cure in the future. | Marianne Sinn Marcus Bahra Timm Denecke Sue Travis Uwe Pelzer Hanno Riess | 2016 | World Journal of Gastrointestinal Oncology2016，8，3： | 3 |
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