Abstract

Pancreatic cancer is one of the most common digestive system cancers. Early diagnosis is difficult owing to the lack of specific symptoms and reliable biomarkers. The cause of pancreatic cancer remains ambiguous. Smoking, drinking, new-onset diabetes, and chronic pancreatitis have been proven to be associated with the occurrence of pancreatic cancer. In recent years, a large number of studies have clarified that a variety of microorganisms colonized in pancreatic cancer tissues are also closely related to the occurrence and development of pancreatic cancer, and the specific mechanisms include inflammatory induction, immune regulation, metabolism, and microenvironment changes caused by microorganism. The mechanism of action of the pancreatic colonized microbiome in the tumor microenvironment, as well as immunotherapy approaches require further study in order to find more evidence to explain the complex relationship between the pancreatic colonized microbiome and PDAC. Relevant studies targeting the microbiome may provide insight into the mechanisms of PDAC development and progression, improving treatment effectiveness and overall patient prognosis. In this article, we focus on the research relating to the microorganisms colonized in pancreatic cancer tissues, including viruses, bacteria, and fungi. We also highlight the microbial diversity in the occurrence, invasion, metastasis, treatment, and prognosis of pancreatic cancer in order to elucidate its significance in the early diagnosis and new therapeutic treatment of pancreatic cancer, which urgently need to be improved in clinical practice. The elimination or increase in diversity of the pancreatic microbiome is beneficial for prolonging the survival of PDAC patients, improving the response to chemotherapy drugs, and reducing tumor burden. The colonization of microorganisms in the pancreas may become a new hotspot in the diagnosis and treatment of pancreatic cancer.

Highlights

  • Pancreatic cancer is the most refractory malignant tumor, owing to its lack of early diagnostic markers, early tendency for neurovascular invasion, rapid deterioration, extensive metastasis to multiple organs, high postoperative recurrence rate, high postoperative distant metastasis rate, poor response to chemoradiotherapy, and several additional characteristics, which lead to an extremely poor prognosis [1]

  • The results showed that gut microbial diversity was decreased in Pancreatic Cancer (PC) with a unique microbial profile, which partly attributed to its decrease of alpha diversity [118]

  • The microbiome colonized in pancreatic tissue or tumor is related to the occurrence, development, treatment response, and survival period of pancreatic cancer

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Summary

INTRODUCTION

Pancreatic cancer is the most refractory malignant tumor, owing to its lack of early diagnostic markers, early tendency for neurovascular invasion, rapid deterioration, extensive metastasis to multiple organs, high postoperative recurrence rate, high postoperative distant metastasis rate, poor response to chemoradiotherapy, and several additional characteristics, which lead to an extremely poor prognosis [1]. The human microbiome is a new target for studying cancer development and treatment It can be directly carcinogenic by promoting an inflammatory response, and may play an anticancer role by changing the tumor immune microenvironment [12]. In contrast to normal pancreatic tissue, a large number of microorganisms, such as bacteria and fungi, colonize the pancreatic cancer tissue. Riquelme et al [17] compared the microbiome with similar specimens and found that the human gut microbiome accounted for 25% of the human tumor microbiome, while the bacterial composition in normal adjacent tissues was different from that in tumors, which indicated the ability of the gut microbiota to colonize pancreatic tumors. The most common group identified in pancreatic cancer tissues was the class Gammaproteobacteria, most of which were Enterobacteriaceae and Pseudomonas, which demonstrated that bacteria colonized the pancreas and were components of the pancreatic cancer tumor microenvironment

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