Pancreatic cancer is one of the most aggressive human malignancies. Its incidence in the United States has tripled in the past 50 years and the tumor is a frequent cause of cancer death in both men and women. In this review we discuss the common molecular alterations and their value as markers of prognosis for pancreatic ductal adenocarcinomas. We describe cytogenetic abnormalities, alterations of oncogenes and tumor suppressor genes, of cell receptors and growth factors, and of factors modulating tumor/stromal interaction playing a role in pancreatic ductal adenocarcinoma. The impact of these changes on cell proliferation, tumor progression and tumor apoptosis is discussed. Finally, a review of gene expression alterations (mRNA microarray and microRNA) and of quantitative proteomic analysis of pancreatic cancer is also presented. Some of the molecules described herein have been shown to represent potential biomarkers of tumor prognosis, and/or of tumor response to therapy. These biomarkers may soon be implemented in the clinical practice to improve the management of patients with pancreatic ductal adenocarcinomas.
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