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World J Clin Oncol. Apr 24, 2026; 17(4): 117197
Published online Apr 24, 2026. doi: 10.5306/wjco.v17.i4.117197
Published online Apr 24, 2026. doi: 10.5306/wjco.v17.i4.117197
Stroma-nerve axis in pancreatic ductal adenocarcinoma: Bidirectional regulatory mechanisms and clinical translation hypothesis
Yi-Nong Yu, Health Science Center, Ningbo University, Ningbo 315211, Zhejiang Province, China
Yi-Nong Yu, Shui-Quan Jin, Lv-Zhou Han, Department of Surgery, Yuyao Hospital of Traditional Chinese Medicine, Ningbo 315400, Zhejiang Province, China
Ye-Ting Lu, Department of Hepatopancreatobiliary Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo Medical Center Lihuili Hospital, Ningbo 315000, Zhejiang Province, China
Co-first authors: Yi-Nong Yu and Shui-Quan Jin.
Author contributions: Yu YN and Jin SQ performed the literature search, integrated the evidence, drafted the manuscript, and they contributed equally to this manuscript and are co-first authors; Lu YT assisted in figure preparation and manuscript editing; Han LZ conceptualized and designed the study, provided overall supervision and critically revised the manuscript. All authors have read and approved the final manuscript.
Supported by Zhejiang Provincial Traditional Chinese Medicine Key Specialty Construction Project, No. ZJZY[2025]12.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Lv-Zhou Han, MM, Associate Faculty, Deputy Director, Department of Surgery, Yuyao Hospital of Traditional Chinese Medicine, No. 1500 Zhongshan South Road, Yuyao City, Ningbo 315400, Zhejiang Province, China. mm2516406664@gmail.com
Received: December 1, 2025
Revised: January 5, 2026
Accepted: February 24, 2026
Published online: April 24, 2026
Processing time: 141 Days and 16.8 Hours
Revised: January 5, 2026
Accepted: February 24, 2026
Published online: April 24, 2026
Processing time: 141 Days and 16.8 Hours
Core Tip
Core Tip: We propose the novel “stroma-nerve axis” framework, conceptualizing nerve fibers and stromal components as a functional unit driving pancreatic ductal adenocarcinoma progression. By defining three hypothetical stroma-nerve axis activation subtypes (nerve-dominant, stroma-dominant, and balanced) and a conceptual Stroma-Nerve Axis Activity Score, this review offers a unified theoretical model to explain therapeutic resistance. This perspective shifts the paradigm from single-target interventions to systematic “network dismantling” strategies, providing a roadmap for future stratified clinical trials.