Cell
Volume 148, Issues 1–2, 20 January 2012, Pages 349-361
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Article
EMT and Dissemination Precede Pancreatic Tumor Formation

https://doi.org/10.1016/j.cell.2011.11.025Get rights and content
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Summary

Metastasis is the leading cause of cancer-associated death but has been difficult to study because it involves a series of rare, stochastic events. To capture these events, we developed a sensitive method to tag and track pancreatic epithelial cells in a mouse model of pancreatic cancer. Tagged cells invaded and entered the bloodstream unexpectedly early, before frank malignancy could be detected by rigorous histologic analysis; this behavior was widely associated with epithelial-to-mesenchymal transition (EMT). Circulating pancreatic cells maintained a mesenchymal phenotype, exhibited stem cell properties, and seeded the liver. EMT and invasiveness were most abundant at inflammatory foci, and induction of pancreatitis increased the number of circulating pancreatic cells. Conversely, treatment with the immunosuppressive agent dexamethasone abolished dissemination. These results provide insight into the earliest events of cellular invasion in situ and suggest that inflammation enhances cancer progression in part by facilitating EMT and entry into the circulation.

Highlights

► Invading cells exhibit EMT in an autochthonous model of pancreatic cancer ► Mutant cells enter the circulation before cancer is found on histology ► Circulating pancreatic cells (CPCs) express cancer stem cell-associated markers ► Inflammation is necessary and sufficient for EMT, invasion, and dissemination

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