Pancreatic Cancer Desmoplastic Reaction and Metastasis
Desmoplastic reaction in pancreatic cancers is characterized by a marked increase in proliferation of stromal cells, accompanied by a synthesis and deposition of tumor-promoting extracellular matrix (ECM) proteins such as collagen, laminin, fibronectin, and vitronectin. Distinct cell types including endothelial cells, immune cells, fibroblasts, endocrine cells and, in particular, pancreatic cancer stellate cells (PSCs) that are embedded in the extracellular matrix constitute the desmoplasia – fibrotic sarcoma – of the pancreatic cancer. In pancreatic cancer, desmoplastic stroma can contribute to 90 % of the tumor volume. Recent studies have shown that the desmoplastic reaction plays a greater role in metastatic tumor progression and drug resistance observed in pancreatic cancer.
Histopathological studies have defined that the desmoplastic reaction is mediated by the copious secretion of different ECM proteins by both the stromal and cancer cells. These ECM...