How fibrosis influences imaging and surgical decisions in pancreatic cancer
Our understanding of pancreatic ductal adenocarcinoma is shifting away from a disease of malignant ductal cells-only, towards a complex system where tumor evolution is a result of interaction of cancer cells with their microenvironment. This change has led to intensification of research focusing on...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2012-10-01
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| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphys.2012.00389/full |
| _version_ | 1819126689098104832 |
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| author | Mert eErkan Simone eHausmann Christoph W Michalski Melissa eSchlitter Alexander A Fingerle Martin eDobritz Helmut eFriess Jörg eKleeff |
| author_facet | Mert eErkan Simone eHausmann Christoph W Michalski Melissa eSchlitter Alexander A Fingerle Martin eDobritz Helmut eFriess Jörg eKleeff |
| author_sort | Mert eErkan |
| collection | DOAJ |
| description | Our understanding of pancreatic ductal adenocarcinoma is shifting away from a disease of malignant ductal cells-only, towards a complex system where tumor evolution is a result of interaction of cancer cells with their microenvironment. This change has led to intensification of research focusing on the fibrotic stroma of pancreatic ductal adenocarcinoma. Pancreatic stellate cells are the main fibroblastic cells of the pancreas which are responsible for producing the desmoplasia in chronic pancreatitis and pancreatic ductal adenocarcinoma. Clinically, the effect of desmoplasia is two-sided; on the negative side it is a hurdle in the diagnosis of pancreatic ductal adenocarcinoma because the fibrosis in cancer resembles that of chronic pancreatitis. It is also believed that pancreatic stellate cells and pancreatic fibrosis are partially responsible for the therapy resistance in pancreatic cancer. On the positive side, a fibrotic pancreas is safer to operate on compared to a fatty and soft pancreas which is prone for postoperative pancreatic fistula. In this review the impact of pancreatic fibrosis on diagnosis of pancreatic cancer and surgical decisions are discussed from a clinical point of view. |
| first_indexed | 2024-12-22T08:00:01Z |
| format | Article |
| id | doaj.art-5db19b76b21e4fcab253a8649bb56285 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-22T08:00:01Z |
| publishDate | 2012-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-5db19b76b21e4fcab253a8649bb562852022-12-21T18:33:17ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2012-10-01310.3389/fphys.2012.0038932219How fibrosis influences imaging and surgical decisions in pancreatic cancerMert eErkan0Simone eHausmann1Christoph W Michalski2Melissa eSchlitter3Alexander A Fingerle4Martin eDobritz5Helmut eFriess6Jörg eKleeff7Klinikum rechts der Isar - Technische Universitaet MuenchenKlinikum rechts der Isar - Technische Universitaet MuenchenKlinikum rechts der Isar - Technische Universitaet MuenchenKlinikum rechts der Isar - Technische Universitaet MuenchenKlinikum rechts der Isar - Technische Universitaet MuenchenKlinikum rechts der Isar - Technische Universitaet MuenchenKlinikum rechts der Isar - Technische Universitaet MuenchenKlinikum rechts der Isar - Technische Universitaet MuenchenOur understanding of pancreatic ductal adenocarcinoma is shifting away from a disease of malignant ductal cells-only, towards a complex system where tumor evolution is a result of interaction of cancer cells with their microenvironment. This change has led to intensification of research focusing on the fibrotic stroma of pancreatic ductal adenocarcinoma. Pancreatic stellate cells are the main fibroblastic cells of the pancreas which are responsible for producing the desmoplasia in chronic pancreatitis and pancreatic ductal adenocarcinoma. Clinically, the effect of desmoplasia is two-sided; on the negative side it is a hurdle in the diagnosis of pancreatic ductal adenocarcinoma because the fibrosis in cancer resembles that of chronic pancreatitis. It is also believed that pancreatic stellate cells and pancreatic fibrosis are partially responsible for the therapy resistance in pancreatic cancer. On the positive side, a fibrotic pancreas is safer to operate on compared to a fatty and soft pancreas which is prone for postoperative pancreatic fistula. In this review the impact of pancreatic fibrosis on diagnosis of pancreatic cancer and surgical decisions are discussed from a clinical point of view.http://journal.frontiersin.org/Journal/10.3389/fphys.2012.00389/fullAngiogenesisstellate cellsmicroenvironmentMolecular diagnosticsdesmoplasiaperiostin |
| spellingShingle | Mert eErkan Simone eHausmann Christoph W Michalski Melissa eSchlitter Alexander A Fingerle Martin eDobritz Helmut eFriess Jörg eKleeff How fibrosis influences imaging and surgical decisions in pancreatic cancer Frontiers in Physiology Angiogenesis stellate cells microenvironment Molecular diagnostics desmoplasia periostin |
| title | How fibrosis influences imaging and surgical decisions in pancreatic cancer |
| title_full | How fibrosis influences imaging and surgical decisions in pancreatic cancer |
| title_fullStr | How fibrosis influences imaging and surgical decisions in pancreatic cancer |
| title_full_unstemmed | How fibrosis influences imaging and surgical decisions in pancreatic cancer |
| title_short | How fibrosis influences imaging and surgical decisions in pancreatic cancer |
| title_sort | how fibrosis influences imaging and surgical decisions in pancreatic cancer |
| topic | Angiogenesis stellate cells microenvironment Molecular diagnostics desmoplasia periostin |
| url | http://journal.frontiersin.org/Journal/10.3389/fphys.2012.00389/full |
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