Pancreatic Cancer

Pancreatic ductal adenocarcinoma (PDAC) represents the most common type of pancreatic cancer, with an increasing incidence. The prognosis for patients with PDAC is unfavorable; although it is a relatively uncommon cancer, it is predicted to become the second-leading cause of cancer-related mortality by 2030 (Park et al. 2021). Given that PDACs are characterized by an infaust prognosis, understanding the mechanisms and pathways through which the nervous system is involved in influencing tumor growth in the pancreas may help to identify new targets for cancer therapy and thereby improve survival of patients with this tumor type. Meanwhile, findings in recent years have shown that neural structures represent an important component of the pancreatic tumor microenvironment that determines the progression of this disease. A frequent adverse finding in PDAC specimens is the presence of neural remodeling and perineural invasion, which are markers of increased aggressiveness of the tumor process and poor prognosis. Neural hypertrophy and increased nerve density can be observed in the pancreatic tumor microenvironment, which is associated with multiple signaling pathways that promote tumor cell invasiveness. Meanwhile, perineural invasion represents one of the primary pathways of tumor cell dissemination, which is responsible for recurrence and metastasis after surgical resection of tumor tissue (Jurcak and Zheng 2019).