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World J Gastroenterol. Aug 21, 2014; 20(31): 10790-10801
Published online Aug 21, 2014. doi: 10.3748/wjg.v20.i31.10790
Cancer stem cells: Involvement in pancreatic cancer pathogenesis and perspectives on cancer therapeutics
Cristiana Pistol Tanase, Ana Iulia Neagu, Laura Georgiana Necula, Cristina Mambet, Ana-Maria Enciu, Bogdan Calenic, Maria Linda Cruceru, Radu Albulescu
Cristiana Pistol Tanase, Ana Iulia Neagu, Laura Georgiana Necula, Cristina Mambet, Ana-Maria Enciu, Bogdan Calenic, Radu Albulescu, Department of Biochemistry-Proteomics, Victor Babes National Institute of Pathology, 050096 sect 5 Bucharest, Romania
Ana Iulia Neagu, Laura Georgiana Necula, Stefan S Nicolau Institute of Virology, 050096 sect 5 Bucharest, Romania
Ana-Maria Enciu, Bogdan Calenic, Maria Linda Cruceru, Carol Davila University of Medicine and Pharmacy, 050474 Sect 5 Bucharest, Romania
Radu Albulescu, National Institute for Chemical Pharmaceutical Research and Development, 050096 sect 5 Bucharest, Romania
Author contributions: Tanase CP and Albulescu R designed the study and critically revised and edited the manuscript; Neagu AI, Necula LG, Mambet C, Enciu AM, Calenic B and Cruceru ML collected the data and composed the draft of manuscript; all authors took part in either drafting the article or revising it critically for important intellectual content.
Supported by Grants POS CCE 685-152/2010 (in part)
Correspondence to: Cristiana Pistol Tanase, MD, PhD, Department of Biochemistry-Proteomics, Victor Babes National Institute of Pathology, no 99-101 Splaiul Independentei, 050096 sect 5 Bucharest, Romania. bioch@vbabes.ro
Telephone: +40-21-31945 28 Fax: +40-21-31945 28
Received: October 29, 2013
Revised: February 7, 2014
Accepted: April 5, 2014
Published online: August 21, 2014
Processing time: 295 Days and 16.8 Hours
Abstract

Pancreatic cancer is one of the most aggressive and lethal malignancies. Despite remarkable progress in understanding pancreatic carcinogenesis at the molecular level, as well as progress in new therapeutic approaches, pancreatic cancer remains a disease with a dismal prognosis. Among the mechanisms responsible for drug resistance, the most relevant are changes in individual genes or signaling pathways and the presence of highly resistant cancer stem cells (CSCs). In pancreatic cancer, CSCs represent 0.2%-0.8% of pancreatic cancer cells and are considered to be responsible for tumor growth, invasion, metastasis and recurrence. CSCs have been extensively studied as of late to identify specific surface markers to ensure reliable sorting and for signaling pathways identified to play a pivotal role in CSC self-renewal. Involvement of CSCs in pancreatic cancer pathogenesis has also highlighted these cells as the preferential targets for therapy. The present review is an update of the results in two main fields of research in pancreatic cancer, pathogenesis and therapy, focused on the narrow perspective of CSCs.

Keywords: Cancer stem cells; Pancreatic cancer; Cancer stem cells signaling pathways; Targeted therapy; miRNA

Core tip: Pancreatic cancer is one of the most aggressive and lethal malignancies, despite remarkable progress in understanding pancreatic carcinogenesis and new therapeutic approaches. The presence of highly resistant cancer stem cells (CSCs) and the changes in their signaling pathways lead to drug resistance in pancreatic cancer. CSCs are considered responsible for tumor growth, invasion, metastasis and recurrence. CSC involvement in pancreatic cancer pathogenesis has also highlighted them as preferential targets for therapy. This review is an update of the results in two main fields of research in pancreatic cancer, pathogenesis and therapy, focused on the narrow perspective of CSCs.