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EZH2 as a Therapeutic Target in Glioblastoma: A Cellular and Molecular Study EZH2作为胶质母细胞瘤的治疗靶点:细胞和分子研究
Pub Date : 2016-12-02 DOI: 10.4172/2157-2518.1000278
J. L. Rosa, Marta Iraburu, G. Gallo-Oller, M. H. Shahi, B. Meléndez, J. Rey, M. Idoate, J. Castresana
Glioblastoma is the most common malignant brain tumor in adults and it is currently treated with a combination of surgery, radiotherapy and chemotherapy with temozolomide (TMZ). Many patients show resistance to TMZ, which is a challenge in the treatment of this type of brain cancer. New strategies are being tested, like the inhibition of EZH2, a histone methyltransferase which is overexpressed in cancer cells, leading to angiogenesis and metastasis. In this work, the EZH2 inhibitor DZNeP was tested in A172 glioblastoma cells and in A172-TMZ-resistant glioblastoma cells. Inhibition of cell proliferation, adhesion, colony formation, and migration was noted in control and TMZresistant glioblastoma cells after DZNeP treatment. At the level of EZH2 target gene expression, DZNeP decreased EZH2 expression, and increased the expression of its target genes (E-cadherin and TIMP3), which might probably contribute to inhibiting the development of a cancer metastatic phenotype. Finally, DZNeP negatively regulated the TGFβ pathway. In conclusion, we propose that inhibition of EZH2 might be considered as a therapeutic strategy against glioblastoma.
胶质母细胞瘤是成人中最常见的恶性脑肿瘤,目前的治疗方法是手术、放疗和化疗联合使用替莫唑胺(TMZ)。许多患者表现出对TMZ的耐药性,这是治疗这类脑癌的一个挑战。新的策略正在测试中,比如抑制EZH2, EZH2是一种在癌细胞中过度表达的组蛋白甲基转移酶,导致血管生成和转移。在这项工作中,EZH2抑制剂DZNeP在A172胶质母细胞瘤细胞和A172- tmz耐药胶质母细胞瘤细胞中进行了测试。DZNeP治疗后,对照和tmz耐药胶质母细胞瘤细胞的增殖、粘附、集落形成和迁移均受到抑制。在EZH2靶基因表达水平上,DZNeP降低了EZH2的表达,增加了其靶基因(E-cadherin和TIMP3)的表达,这可能有助于抑制癌症转移表型的发生。最后,DZNeP负向调控tgf - β通路。总之,我们建议抑制EZH2可能被认为是一种治疗胶质母细胞瘤的策略。
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引用次数: 1
Dual Parallel Sequence Progression as Vascular Pseudo-Reactivities to Tumor Necrosis and to Proliferation of Glioblastoma Cells 双平行序列进展作为血管对肿瘤坏死和胶质母细胞瘤细胞增殖的伪反应
Pub Date : 2016-11-25 DOI: 10.4172/2157-2518.1000277
L. Agius
Directional projections of glioblastoma biology include the constitutive clonality of a lesion that infiltrates in terms of its established potential proliferation involving predominantly poorly differentiated cell populations. In large measure, inclusive parameters correlate with the presence of contrastingly different types of genetic lesion, such as for example, the implication of p53 mutation versus the amplification/over-expression of the Epidermal Growth Factor Receptor (EGFR) in the neoplastic cells. Involvement of vasculature and of intense vascularization of multiple foci of the evolving glioblastoma emphasizes the distinctive link to multiple foci of tumor necrosis. Collaborative features include also an apparent propensity for pseudo-multifocality arising from processes of highly active foci of infiltration within the white matter. Cancer stem cells are believed to be the propagating cell component in gliomas and may differ from glioma initiating cells responsible for the establishment and survival of the neoplasm. Therapeutic resistance may specifically relate to resistance of the glioma stem cells that are found in small numbers in the tumor. Patient age is a distinctive feature of glioblastoma that progresses in close parallel with the vasculogenesis in neoplastic cell infiltration of adjacent tracts such as the corpus callosum and also the cerebral white matter of one or both cerebral hemispheres.
胶质母细胞瘤生物学的定向预测包括病变浸润的构成性克隆,就其确定的潜在增殖涉及主要低分化细胞群而言。在很大程度上,包容性参数与不同类型遗传病变的存在相关,例如,p53突变与肿瘤细胞中表皮生长因子受体(EGFR)扩增/过表达的含义。演变中的胶质母细胞瘤的多灶性血管的浸润和强烈的血管化强调了与肿瘤坏死的多灶性的独特联系。协同特征还包括由白质内高度活跃的浸润灶过程引起的明显的伪多灶性倾向。肿瘤干细胞被认为是胶质瘤的增殖细胞成分,可能不同于胶质瘤起始细胞,负责肿瘤的建立和存活。治疗耐药可能与肿瘤中少量发现的胶质瘤干细胞的耐药有关。患者的年龄是胶质母细胞瘤的一个显著特征,其进展与相邻束(如胼胝体)的肿瘤细胞浸润血管形成密切平行,也与一侧或两侧大脑半球的脑白质密切平行。
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引用次数: 0
Association between Exposure to Estrogenic Endocrine Disruptors - Polychlorinated Biphenyls, Phthalates, and Bisphenol A and Gynecologic Cancers- Cervical, Ovarian, Uterine Cancers 暴露于雌激素内分泌干扰物-多氯联苯,邻苯二甲酸盐和双酚A与妇科癌症-宫颈癌,卵巢癌,子宫癌之间的关系
Pub Date : 2016-10-31 DOI: 10.4172/2157-2518.1000275
Marisa Morgan, A. Deoraj, Q. Felty, C. Yoo, D. Roy
Introduction: Estrogen is a driver in the growth and progression of gynecologic cancers (cervical, ovarian, and uterine). A number of estrogenically active chemicals are suspected to contribute in the development of gynecologic lesions, including an increased risk of estrogen-dependent cancer in women. Humans are exposed to estrogenic endocrine disruptors (EEDs), such as- polychlorinated biphenyls (PCBs), phthalates and bisphenol A (BPA). Therefore, we examined the cross-sectional relationship between exposure to PCBs, phthalates, and BPA and gynecologic cancers (cervical, ovarian, and uterine). Methods: We analyzed data from female participants (20 years of age and older) who provided blood and urine samples for the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey (NHANES) between 1999 and 2010. Exposure was examined based on lipid adjusted serum levels of 6 individual PCB congeners (74, 99, 118, 138, 153, and 180), the sum of dioxin-like PCBs (074 and 118), the sum of non-dioxin-like PCBs (099+138+153+187), 8 urinary phthalate metabolites (MNP, MEP, MEHP, MBzP, MCPP, MEHHP, MEOHP, and MIB), the sum of DEHP metabolites (MHP+MHH+MOH), the sum of total phthalates, and urinary BPA in conjunction with data obtained from the medical and reproductive health questionnaires. We calculated geometric means to compare EEDs concentrations in women who self-reported a cervical, ovarian, or uterine cancer diagnosis vs. women who self-reported never being diagnosed with cancer. We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between exposure to EEDs and r gynecologic cancers. We also evaluated age, race/ethnicity, body mass index (BMI; kg/m2), and age at menarche as potential confounding variables in our final models. Results: Separate analyses showed weighted geometric mean (GM) levels of individual PCB congeners to be significantly higher among women with ovarian cancer, and uterine cancer when compared to the rest of the study population. Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) was found to be significantly higher and BPA was higher among women with ovarian cancer compared to women never diagnosed with any gynecologic cancer. After adjusting for age, race, BMI, and age at menarche, we found that PCB 138 was significantly associated with cervical cancer, and uterine cancer [odds ratios of 3.05, 95% CI: 1.21-7.69; and 5.83, 95% CI: 1.63-20.9], respectively. PCB 74 and 118 however, were significantly associated with ovarian cancer with an odds ratios of 6.47, 95% CI: 1.23-3.41 (for PCB 74) and 6.68, 95% CI: 1.39-32.3 (for PCB 118). We also found the sum of non-dioxin-like PCBs to be significantly associated with uterine cancer (OR of 1.12, 95% CI: 1.03-1.23) and the sum of dioxin-like PCBs to be significantly associated with ovarian cancer (OR of 2.02, 95% CI: 1.06-3.85). We did not find significant associations between urinary phthalate
引言:雌激素是妇科癌症(子宫颈癌、卵巢癌和子宫癌)生长和进展的驱动因素。一些雌激素活性化学物质被怀疑在妇科病变的发展中起作用,包括增加女性雌激素依赖性癌症的风险。人类暴露于雌激素内分泌干扰物(eed),如多氯联苯(pcb)、邻苯二甲酸盐和双酚A (BPA)。因此,我们研究了暴露于多氯联苯、邻苯二甲酸酯和双酚a与妇科癌症(宫颈癌、卵巢癌和子宫癌)之间的横断面关系。方法:我们分析了1999年至2010年间为疾病控制与预防中心的国家健康与营养检查调查(NHANES)提供血液和尿液样本的女性参与者(20岁及以上)的数据。暴露检查基于脂质调整血清水平的6个人PCB副产品(74,99,118,138,153,和180年),类二恶英多氯联苯的总和(074和118),non-dioxin-like多氯联苯的总和(099 + 138 + 153 + 187),8尿邻苯二甲酸酯代谢物(MNP、议员、MEHP MBzP, MCPP, MEHHP, MEOHP,和MIB), DEHP的总和代谢物(MHP + MHH +卫生部、总邻苯二甲酸酯的总和,尿BPA与从医学和生殖健康调查问卷获得的数据。我们计算几何平均数来比较自我报告宫颈癌、卵巢癌或子宫癌诊断的妇女与自我报告从未被诊断为癌症的妇女的ed浓度。我们使用逻辑回归模型来估计暴露于ed和妇科癌症之间的比值比(ORs)和95%置信区间(ci)。我们还评估了年龄、种族/民族、体重指数(BMI;Kg /m2),初潮年龄是我们最终模型中潜在的混杂变量。结果:单独的分析显示,与其他研究人群相比,患有卵巢癌和子宫癌的女性中PCB同系物的加权几何平均(GM)水平明显更高。研究发现,与从未被诊断患有任何妇科癌症的女性相比,患卵巢癌的女性中邻苯二甲酸单-(2-乙基-5-羟基己基)酯(MEHHP)和双酚a的含量明显更高。在调整了年龄、种族、BMI和初月经年龄后,我们发现PCB 138与宫颈癌和子宫癌显著相关[比值比为3.05,95% CI: 1.21-7.69;和5.83,95% CI: 1.63-20.9]。然而,PCB 74和118与卵巢癌显著相关,比值比为6.47,95% CI: 1.23-3.41 (PCB 74)和6.68,95% CI: 1.39-32.3 (PCB 118)。我们还发现,非二恶英样多氯联苯总量与子宫癌显著相关(OR为1.12,95% CI: 1.03-1.23),二恶英样多氯联苯总量与卵巢癌显著相关(OR为2.02,95% CI: 1.06-3.85)。我们没有发现尿邻苯二甲酸酯和双酚a与妇科癌症之间的显著关联。结论:我们的研究结果指出,多氯联苯环境暴露与子宫颈、卵巢癌和子宫癌风险增加之间可能存在关联。然而,由于自我报告的横截面数据和有限的妇科癌症样本量,这些发现应谨慎解释。
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引用次数: 13
ALS and Cancer 渐冻症与癌症
Pub Date : 2016-10-31 DOI: 10.4172/2157-2518.1000E122
M. Yamaguchi, Y. Azuma, H. Yoshida
Amyotrophic Lateral Sclerosis (ALS) is a rare but very severe disease. In ALS patients, defect in motor neuron accompanied with muscle atrophy progresses rapidly that results in defect in locomotion, swallowing and respiration. Patients normally die in 2 to 5 years after the onset of disease, if the artificial ventilator is not equipped. However, up to now there is no effective therapy. A number of epidemiological studies suggested that ALS relates to cancer. It has been shown that prostate cancer survivors are associated with a decreased risk of ALS [1]. In the contrary, a significantly elevated risk of ALS among survivors of melanoma and tongue cancer has been also reported [1]. ALS and cancer share defects in various cellular processes including cell survival, cell death and cell cycle. However, in ALS the defects results in progressive defect of motor neuron, while in cancer it results in uncontrolled cell survival and proliferation [1]. More than thirty ALS-causing genes have been identified and every year still new ALS-causing gene is reported. Some of them appear to be involved in not only ALS but also cancer as summarized below and in Table 1.
肌萎缩侧索硬化症(ALS)是一种罕见但非常严重的疾病。肌萎缩侧索硬化症患者运动神经元缺损伴肌肉萎缩进展迅速,导致运动、吞咽和呼吸功能缺损。如果没有配备人工呼吸机,患者通常在发病后2至5年内死亡。然而,目前尚无有效的治疗方法。一些流行病学研究表明ALS与癌症有关。研究表明,前列腺癌幸存者与ALS风险降低相关[1]。相反,也有报道称黑色素瘤和舌癌幸存者患ALS的风险显著升高[1]。肌萎缩侧索硬化症和癌症在细胞存活、细胞死亡和细胞周期等多种细胞过程中存在共同的缺陷。然而,在肌萎缩侧索硬化症中,缺陷导致运动神经元的进行性缺陷,而在癌症中,缺陷导致细胞存活和增殖失控[1]。目前已鉴定的als致病基因有30多种,每年仍有新的als致病基因被报道。其中一些似乎不仅与肌萎缩侧索硬化症有关,还与癌症有关,如下表1所示。
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引用次数: 5
Importance of a Multidisciplinary Approach to Breast Cancer Treatment in Pregnancy: Case Report of New Diagnosis of Pregnancy-Associated Breast Cancer 多学科方法对妊娠期乳腺癌治疗的重要性:妊娠相关乳腺癌新诊断病例报告
Pub Date : 2016-10-18 DOI: 10.4172/2157-2518.1000279
J. Grant, C. Dicarlo, J. Woessner-Hoyson
Pregnancy-Associated Breast Cancer (PABC) is a rare diagnosis and includes new diagnoses of cancer both during pregnancy as well as within the first year post-delivery. Due to its rarity, there is of yet no gold standard treatment nor is there a standardized regimen of treatment during pregnancy according to the American College of Obstetrics and Gynecology (ACOG). We report a case involving a 35-year-old gravida 2 para 1-0-0-1 who was diagnosed with clinical stage II (T2 N1) breast cancer in the early third trimester of pregnancy after physical examination revealed a palpable mass. Ultrasound-guided biopsy revealed poorly differentiated infiltrating ductal carcinoma, nuclear grade 3, with micropapillary features, estrogen receptor (ER 90%), progesterone receptor (PR 25%) positive, HER2 positive 3+ with Ki67 index 75%. After extensive counseling and discussion between Obstetrics, Maternal Fetal Medicine, Breast Surgery, Neonatal ICU, and Oncology, a decision was made to initiate neoadjuvant chemotherapy (NAC) with adriamycin and cyclophosphamide. Our patient completed 4 total NAC treatments prior to delivery followed by a regimen of weekly taxol plus herceptin and perjeta postpartum. This patient strongly desired to carry the pregnancy to term and began treatment prior to delivery, making this case unique in comparison to other publications in which treatment was delayed until after delivery, or the pregnancy was terminated prior to beginning treatment. Our case highlights the importance of a multi-disciplinary approach to counseling patients in this unique situation to allow them the autonomy to choose the treatment best for them and their baby.
妊娠相关乳腺癌(PABC)是一种罕见的诊断,包括在怀孕期间以及分娩后一年内新诊断的癌症。根据美国妇产科学院(ACOG)的说法,由于其罕见性,目前还没有黄金标准治疗方法,也没有怀孕期间的标准化治疗方案。我们报告一位35岁的孕妇,她在妊娠晚期早期被诊断为临床II期(T2 N1)乳腺癌,体检发现可触及的肿块。超声引导下活检示低分化浸润性导管癌,核3级,微乳头状征,雌激素受体(ER) 90%,孕激素受体(PR) 25%阳性,HER2阳性3+,Ki67指数75%。经过产科、母胎医学、乳腺外科、新生儿ICU和肿瘤科的广泛咨询和讨论,决定启动阿霉素和环磷酰胺的新辅助化疗(NAC)。我们的患者在分娩前完成了4次NAC治疗,随后是每周紫杉醇加赫赛汀和产后perjeta的治疗方案。该患者强烈希望怀孕至足月,并在分娩前开始治疗,与其他延迟治疗至分娩后或在开始治疗前终止妊娠的文献相比,该病例是独一无二的。我们的案例强调了在这种特殊情况下,采用多学科方法对患者进行咨询的重要性,使他们能够自主选择最适合自己和孩子的治疗方法。
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引用次数: 1
2,3,7,8-Tetrachlorodibenzo-p-dioxin: Genotoxicity and Oxidative Damage Potential in Human Peripheral Blood Lymphocytes 2,3,7,8-四氯二苯并-对二恶英:人类外周血淋巴细胞的遗传毒性和氧化损伤潜力
Pub Date : 2016-10-10 DOI: 10.4172/2157-2518.1000274
G. Güler, A. Çelik
Dioxin-like compounds, e.g. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzo-furans (PCDFs) and dioxin-like polychlorinated biphenyls (PCBs) are a widespread and diverse group of persistent, lipophilic and hazardous environmental pollutants. Additionally, because they are by-products of chlorine- containing manufacturing process and incineration, they represent a serious environmental problem. In this research study; we investigated the genotoxic and oxidative effects of TCDD using single cell gel electrophoresis/COMET assay and measuring levels of catalase, superoxide dismutase enzymes, and malondialdehyde values for lipid peroxidation in peripheral blood lymphocyte cultures at three different doses. Blood samples were taken from healthy non-smoking male subjects by venipuncture. In this study, the three doses of 2,3,7,8-tetrachlorodibenzo-p-dioxin were used as 62.5 ng/ml, 31.25 ng/ml, 15.625 ng/ml. In comet assay, two different parameters were evaluated. Damaged cell percent (DCP). Genetic damage index (GDI). Both GDI and DCP significantly increased in a dose-dependent manner at statistical level. There is no statistically significant difference the levels of catalase, superoxide dismutase enzymes, malondialdehyde values compared with negative control.
类二恶英化合物,如2,3,7,8-四氯二苯并-对二恶英(TCDD)、多氯二苯并-对二恶英(pcdd)、多氯二苯并呋喃(pcdf)和类二恶英多氯联苯(PCBs)是一类广泛和多样的持久性、亲脂性和有害的环境污染物。此外,由于它们是含氯制造过程和焚烧的副产品,它们代表了严重的环境问题。在本研究中;我们使用单细胞凝胶电泳/COMET法研究了TCDD的遗传毒性和氧化作用,并测量了三种不同剂量下外周血淋巴细胞培养中过氧化氢酶、超氧化物歧化酶和丙二醛的水平,以促进脂质过氧化。通过静脉穿刺从健康的非吸烟男性受试者中抽取血液样本。在本研究中,2,3,7,8-四氯二苯并-对二恶英三种剂量分别为62.5 ng/ml、31.25 ng/ml、15.625 ng/ml。在彗星试验中,评估了两个不同的参数。受损细胞百分比(DCP)。遗传损伤指数(GDI)。GDI和DCP均在统计学水平上呈剂量依赖性增加。过氧化氢酶、超氧化物歧化酶、丙二醛水平与阴性对照组比较,差异无统计学意义。
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引用次数: 3
Water: The First Archaic Mutagen of Evolution, the Adoptive Mother of Currently Nucleic Acids 水:进化的第一个古老的突变原,现代核酸的养母
Pub Date : 2016-09-27 DOI: 10.4172/2157-2518.1000E121
F. Caradonna
Within the series of evolutions which start from the origin of the universe and still cannot, by definition, be considered concluded, certainly among the geothermal evolution end and the beginning of the chemical one, on Earth, the moment was favorable for the arrival of the first proto-nucleotides: from underground deposits of methanehydrate [1] and phosphate, with the support of all known pre-biotic physical-chemical conditions, were made the monomeric components of nucleic acids. The cradle of nucleic acids does not seem to have been so fundamentally aqueous, but organic. In fact, thinking back that “all the major biopolymers are metastable in aqueous solution” [2], it is easy to conclude that in those days a proto-nucleotide, or better its carbohydrate, in the aqueous phase would have shown all its inadequacy. However, knowing how today is made a nucleic acid, it is evident that the fine evolutionary strategy has distinguished, for this event, two necessities and consequently has chosen two evolutionary times and two different environments to achieve them:
在从宇宙起源开始的一系列进化中,根据定义,仍然不能被认为是结束的,当然在地热进化的结束和化学进化的开始之间,在地球上,这是有利于第一个原始核苷酸到来的时刻:从地下甲烷水合物[1]和磷酸盐的沉积物中,在所有已知的前生物物理化学条件的支持下,核酸的单体成分被制造出来。核酸的摇篮似乎根本不是水,而是有机的。事实上,回想一下“所有主要的生物聚合物在水溶液中都是亚稳的”[2],我们很容易得出这样的结论:在那个年代,一个原核苷酸,或者说它的碳水化合物,在水相中会显示出它的全部不足。然而,了解了今天核酸是如何产生的,很明显,精细的进化策略为这一事件区分了两种必要性,因此选择了两个进化时间和两种不同的环境来实现它们:
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引用次数: 0
Multiple Myeloma Relapsed with Skull Involvement in Plasmacytoma 多发性骨髓瘤复发伴浆细胞瘤累及颅骨
Pub Date : 2016-08-05 DOI: 10.4172/2157-2518.1000273
Y. Kayar, Nuket Bayram Kayar, I. Ekinci, G. Çoban, N. Unver
Extra medullary plasmacytomas occurring as solitary (primary) tumours or secondary manifestations of multiple myeloma most often involve the upper airways and paranasal sinuses. The skull is one of the rarest sites of extra medullary plasmacytoma. Myelomatous deposits in dural reflections distant from the bony skull, i.e. tentorium and falx, are rarer, and probably result from dissection along layers of meninges. Osseous and pachymeningeal masses in the cranial vault or in the skull base may result in tumefaction, pain, headache, single or multiple cranial nerve palsies or seizure. A case of multiple myeloma relapsed with extra medullary plasmacytoma in the skull; forehead and ear involvement is reported.
髓外浆细胞瘤作为孤立的(原发性)肿瘤或多发性骨髓瘤的继发表现,最常累及上呼吸道和鼻窦。颅骨是髓外浆细胞瘤最罕见的部位之一。距颅骨较远的硬脑膜反射区(如幕和镰)的骨髓瘤沉积较少见,可能是由于沿脑膜层剥离所致。颅顶或颅底的骨性和厚脑膜肿块可引起肿胀、疼痛、头痛、单发或多发脑神经麻痹或癫痫发作。多发性骨髓瘤复发合并颅骨髓外浆细胞瘤1例前额和耳朵也有受累的报道。
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引用次数: 1
Juvenile Granulosa Cell Tumor - A Rare Neoplasm in Newborns 幼年颗粒细胞瘤——一种罕见的新生儿肿瘤
Pub Date : 2016-07-22 DOI: 10.4172/2157-2518.1000I101
O. Oral, E. Ozer, E. Kaymaz, S. Hucumenoglu
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引用次数: 1
Carcinoma Associated Fibroblast: A Paradoxical Role in Pancreatic Cancer Microenvironment and a Promising Target for Therapy 癌相关成纤维细胞:在胰腺癌微环境中的矛盾作用和一个有希望的治疗靶点
Pub Date : 2016-07-15 DOI: 10.4172/2157-2518.1000271
J. Yang, X. Bail, T. Liang
Pancreatic cancer is a grave malignancy showing an upward trend in morbidity and mortality during the recent decades. For reasons of late diagnosis, chemoresistance, low potential respectable rate and high post-operative recurrence rate, it has been the 6th most common cause of cancer death in China. As one of the most aggressive malignancies and the most common type of pancreatic cancer, pancreatic adenocarcinoma (PDAC) represents a significant therapeutic challenge. Conventional chemotherapeutic cytotoxic agents are proved to be with a poor survival benefit. Though the current first-line therapy FOLFIRINOX increased the median survival time compared with gemcitabine, it has been still unsatisfactory. Another direction enlighted by the treatement experience in other tumors is targeting certain molecules that participate in specific signaling pathways mediating cancer cell proliferating, angiogenesis, chemoresistance or metastasis. Unfortunately, none of the established "targeted" therapy agents that have been approved to be effective in some other tumors has a similar effect on PDAC, suggesting that there are some unique and decisive elements in the microenvironment of PDAC to facilitate its extensive drugresistance. Thus, the spotlight has been turned on immunotherapy, which is theoretically curative regardless of the complex molecular and cellular heterogeneity while the concrete strategies on PDAC are still in the dark. Revisiting the complex biology of PDAC, three prime characteristics will never be missed: almost 90% of patients with oncogene mutation of KRAS, as well as loss of tumor suppressor genesTP53 and SMAD4; mostly hypovascular; and tumor desmoplasia by persistent activation of fibroblasts/ pancreatic stellate cells (PSC). The last one, which is the defining feature of PDAC, as the target of therapy is the focus of this review.
胰腺癌是一种严重的恶性肿瘤,近几十年来发病率和死亡率呈上升趋势。由于诊断晚、耐药、潜在体面率低、术后复发率高等原因,已成为中国癌症死亡的第六大常见原因。作为最具侵袭性的恶性肿瘤和最常见的胰腺癌类型之一,胰腺腺癌(PDAC)代表了一个重大的治疗挑战。传统的化疗细胞毒性药物被证明具有较差的生存效益。虽然目前的一线治疗FOLFIRINOX比吉西他滨增加了中位生存时间,但它仍然不令人满意。其他肿瘤的治疗经验启示的另一个方向是靶向参与介导癌细胞增殖、血管生成、化疗耐药或转移的特定信号通路的某些分子。不幸的是,没有一种已被批准对其他肿瘤有效的既定“靶向”治疗药物对PDAC具有类似的作用,这表明PDAC的微环境中存在一些独特和决定性的因素,促进了其广泛的耐药。因此,免疫疗法已经成为人们关注的焦点,尽管PDAC具有复杂的分子和细胞异质性,但理论上免疫疗法是可以治愈的,而PDAC的具体策略仍然是未知的。回顾PDAC的复杂生物学,我们永远不会错过三个主要特征:几乎90%的KRAS癌基因突变患者,以及肿瘤抑制基因estp53和SMAD4的缺失;大部分hypovascular;并通过持续激活成纤维细胞/胰腺星状细胞(PSC)来促进肿瘤结缔组织的形成。最后一个是PDAC的特征,作为治疗的目标是本文的重点。
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引用次数: 2
期刊
Journal of carcinogenesis & mutagenesis
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