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Pancreatic cancer:Translational research aspects and clinical implications

World Journal of Gastroenterology 2012年第13期18卷 1417-1424页

作者： Daniel Ansari Bi-Cheng Chen Lei Dong Meng-Tao Zhou Roland Andersson Daniel Ansari Roland Andersson Department of SurgeryClinical Sciences Lund Sk~ne University Hospital and LundUniversity SE-221 85 Lurid Sweden Provincial Top KeyDiscipline in Surgery Wenzhou Key Laboratory of Surgery De-partment of Surgery First Affiliated Hospital Wenzhou MedicalCollege Wenzhou 325000 Zhejiang Province China Department of Pathology First Affiliated HospitalWenzhou Medical Collegc Wenzhou 325000 Zhejiang ProvinceChina

Despite improvements in surgical techniques and adjuvant chemotherapy, the overall mortality rates in pan- creatic cancer have generally remained relatively un-changed and the 5-year survival rate is actually below 2%. This paper will address the importance of achieving an early diagnosis and identifying markers for prog- nosis and response to therapy such as genes, proteins, microP, NAs or epigenetic modifications. However, there are still major hurdles when translating investigational biomarkers into routine clinical practice. Furthermore, novel ways of secondary screening in high-risk individu- als, such as artificial neural networks and modern imaging, will be discussed. Drug resistance is ubiquitous in pancreatic cancer. Several mechanisms of drug resistance have already been revealed, including human equilibrative nucleoside transporter-1 status, multidrug resistance proteins, aberrant signaling pathways, mi-croRNAs, stromal influence, epithelial-mesenchymal transition-type cells and recently the presence of can- cer stem cells/cancer-initiating cells. These factors must be considered when developing more customized types of intervention （＇personalized medicine＇S. In the future, multifunctional nanoparticles that combine a specific targeting agent, an imaging probe, a cell-penetrating agent, a biocompatible polymer and an anti-cancer drug may become valuable for the management of pa- tients with pancreatic cancer.

关键词： Pancreatic cancer Biomarkers Imaging Artifi-cial neural networks nanomedicine, personalized medicine

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