[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-379201-105":59,"doc-detail-379201-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","multifaced-roles-of-desmoplastic-reaction-and-fibrosis-in-pancreatic-cancer-progression-current-understanding-and-future-directions","Multifaced roles of desmoplastic reaction and fibrosis in pancreatic cancer progression: Current understanding and future directions","","Desmoplastic reaction is a fibrosis process marked by abundant dense extracellular matrix (ECM) and fibrous stroma that develops around pancreatic tumors. The fibrotic stroma includes myofibroblasts, collagen, and other ECM molecules, arising from tissue injury responses and acting as a key driver of pancreatic cancer development. This stromal reaction links to tumor progression, metastasis, and poor prognosis through cytokine/chemokine, MMP, and growth factor signaling, immune suppression via Treg recruitment, restricted nutrient/oxygen delivery, and physical barriers that reduce drug entry and contribute to therapy resistance.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/multifaced-roles-of-desmoplastic-reaction-and-fibrosis-in-pancreatic-cancer-progression-current-understanding-and-future-directions/379201/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/multifaced-roles-of-desmoplastic-reaction-and-fibrosis-in-pancreatic-cancer-progression-current-understanding-and-future-directions/379201.png","ImageObject",300,407,{"name":92,"@type":93},"Aditya","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",17,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is desmoplastic reaction in pancreatic cancer?","Question",{"text":113,"@type":114},"Desmoplastic reaction is a fibrosis-related process characterized by dense extracellular matrix and fibrous stroma surrounding the tumor.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does fibrosis contribute to pancreatic cancer progression and prognosis?",{"text":118,"@type":114},"Fibrotic stroma is associated with tumor progression, metastasis, and poor prognosis, driven by signaling pathways that support growth and immune suppression.",{"name":120,"@type":111,"acceptedAnswer":121},"Why does dense fibrosis increase drug resistance?",{"text":122,"@type":114},"Dense fibrosis restricts nutrient and oxygen flow and forms physical barriers that block drug entry into tumor cells, reducing treatment effectiveness.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},379201,1790741403,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962085564549,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Received: 5 February 2023 | Revised: 28 May 2023 | Accepted: 6 June 2023  \nDOI: 10. 1111/cas.15890  \nR E V I E W A RTI C LE  \nMultifaced roles of desmoplastic reaction and fibrosis in pancreatic cancer progression: Current understanding and future directions  \nHiromichi Sato1,2 | Tomoaki Hara1 | Sikun Meng1 | Yoshiko Tsuji1 | Yasuko Arao1 | Yoshiko Saito1 | Kazuki Sasaki1,2 | Shogo Kobayashi2 | Yuichiro Doki2 |  \nHidetoshi Eguchi2  | Hideshi Ishii1   \n1Department of Medical Data Science, Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Osaka, Japan  \n2Department of Gastrointestinal Surgery, Osaka University Graduate School of Medicine, Osaka, Japan  \nCorrespondence  \nHideshi Ishii, Department of Medical Data Science, Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan.  \nEmail: [hishii@gesurg. med.osaka-u.ac.jp](hishii@gesurg. med.osaka-u.ac.jp)  \nFunding information  \nGrant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Grant/ Award Number: 17cm0106414h0002, JP21lm0203007, 18KK0251, 19K2265, 20H00541, 21K19526, 22H03146, 22K19559 and 16H06279; Mitsubishi Foundation  \nAbstract  \nDesmoplastic reaction is a fibrosis reaction that is characterized by a large amount of dense extracellular matrix (ECM) and dense fibrous stroma. Fibrotic stroma around the tumor has several different components, including myofibroblasts, collagen, and other ECM molecules. This stromal reaction is a natural response to the tissue injury process, and fibrosis formation is a key factor in pancreatic cancer development. The fibrotic stroma of pancreatic cancer is associated with tumor progression, metastasis, and poor prognosis. Reportedly, multiple processes are involved in fibrosis, which is largely associated with the upregulation of various cytokines, chemokines, matrix metalloproteinases, and other growth factors that promote tumor growth and metastasis. Fibrosis is also associated with immunosuppressive cell recruitment, such as regulatory T cells (Tregs) with suppressing function to antitumor immunity. Further, dense fibrosis restricts the flow of nutrients and oxygen to the tumor cells, which can contribute to drug resistance. Furthermore, the dense collagen matrix can act as a physical barrier to block the entry of drugs into the tumor, thereby further contributing to drug resistance. Thus, understanding the mechanism of desmoplastic reaction and fibrosis in pancreatic cancer will open an avenue to innovative medicine and improve the prognosis of patients suffering from this disease.  \nK E Y WO R D S  \ncancer, desmoplastic reaction, fibroblasts, fibrosis, pancreas  \nAbbreviations: CAFs, cancer-associated fibroblasts; CF, cystic fibrosis; CTGF, connective tissue growth factor; DNA, deoxyribonucleic acid; ECM, extracellular matrix; EMT, epithelial–mesenchymal transition; FGF, fibroblast growth factor; FGFR, fibroblast growth factor receptor; HA, hyaluronic acid; HDAC, histone deacetylase; HGF, hepatocyte growth factor; HIF1, hypoxia-inducible factor 1; IL, interleukin; MMPs, matrix metalloproteinases; NF-κB, nuclear factor–kappa B; PDGF, platelet-derived growth factor; PD-L1, programmed death-ligand 1; PSC, pancreatic stellate cell; RNA, ribonucleic acid; TGFB, transforming growth factor beta; TIMP-1, tissue inhibitor of metalloproteinase 1; TNF, tumor necrosis factor; Treg, regulatory T cell.  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.  \n© 2023 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.  \n1 | INTRODUCTION  \nDesmoplastic reaction is a phenomenon in many cancers, i","cbCaiaHHpgN0eZMA","https://ap.wps.com/l/cbCaiaHHpgN0eZMA","pdf",4290876,"English","# Abstract\n# Keywords\n# 1. INTRODUCTION\n# 2. DES MO PLASTIC REACTION AND FIBROSIS","[{\"question\":\"What is desmoplastic reaction in pancreatic cancer?\",\"answer\":\"Desmoplastic reaction is a fibrosis-related process characterized by dense extracellular matrix and fibrous stroma surrounding the tumor.\"},{\"question\":\"How does fibrosis contribute to pancreatic cancer progression and prognosis?\",\"answer\":\"Fibrotic stroma is associated with tumor progression, metastasis, and poor prognosis, driven by signaling pathways that support growth and immune suppression.\"},{\"question\":\"Why does dense fibrosis increase drug resistance?\",\"answer\":\"Dense fibrosis restricts nutrient and oxygen flow and forms physical barriers that block drug entry into tumor cells, reducing treatment effectiveness.\"}]","Multifaced roles of desmoplastic reaction and fibrosis in pancreatic cancer progression: Current understanding and future directions | PDF",1790234583,23]