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September-2026 Volume 32 Issue 3

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Review

Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review)

  • Authors:
    • Yanjun Lou
    • Yiqun Fan
  • View Affiliations / Copyright

    Affiliations: Department of Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, Zhejiang 322000, P.R. China, Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
  • Article Number: 391
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    Published online on: July 3, 2026
       https://doi.org/10.3892/ol.2026.15746
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Abstract

Pancreatic cancer is a highly aggressive malignancy with limited therapeutic options and poor survival outcomes, highlighting the need for an improved understanding of its underlying biology. Advances have positioned the human microbiome as a critical regulator of the initiation and progression of pancreatic cancer. Microbial communities across the oral‑gut‑tumor axis contribute to tumor initiation through coordinated mechanisms, including the induction of genotoxic stress, chronic inflammation and activation of oncogenic signaling pathways. During tumor progression, microbiota dynamically shape the tumor microenvironment by modulating immune responses, metabolic reprogramming and stromal remodeling. Notably, microbial influences are bidirectional, as tumor‑promoting and tumor‑suppressive taxa exert opposing effects that converge on shared regulatory pathways within the tumor ecosystem. The present study reviews the current understanding of microbiome involvement in pancreatic cancer, focusing on its mechanistic roles in tumor initiation and progression. Furthermore, the key challenges in the field are discussed, and the emerging opportunities for therapeutic intervention are highlighted. These insights provide a conceptual framework for integrating microbiome research into precision oncology for pancreatic cancer.
View Figures

Figure 1

Microbiome-tumor interactions in
pancreatic cancer initiation and progression. Oral, gut and
intratumoral microbiota may promote tumor initiation through
persistent activation of NF-κB signaling, induction of genotoxic
stress by microbial toxins and inflammatory mediators, and
activation of oncogenic pathways such as PI3K and MAPK. During
disease progression, microbial metabolites and microbial-associated
molecular patterns reshape the tumor microenvironment by enhancing
inflammation, promoting recruitment of myeloid-derived suppressor
cells and tumor-associated macrophages, impairing cytotoxic T-cell
function, and facilitating immune evasion and desmoplastic stromal
remodeling. Conversely, selected microbial taxa may support
antitumor immunity through immune activation and maintenance of
tissue homeostasis. This figure was created with BioGDP.com. ECM,
extracellular matrix; NK, natural killer; PanIN, pancreatic
intraepithelial neoplasia; SCFA, short-chain fatty acid; TME, tumor
microenvironment.
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Copy and paste a formatted citation
Spandidos Publications style
Lou Y and Fan Y: Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review). Oncol Lett 32: 391, 2026.
APA
Lou, Y., & Fan, Y. (2026). Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review). Oncology Letters, 32, 391. https://doi.org/10.3892/ol.2026.15746
MLA
Lou, Y., Fan, Y."Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review)". Oncology Letters 32.3 (2026): 391.
Chicago
Lou, Y., Fan, Y."Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review)". Oncology Letters 32, no. 3 (2026): 391. https://doi.org/10.3892/ol.2026.15746
Copy and paste a formatted citation
x
Spandidos Publications style
Lou Y and Fan Y: Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review). Oncol Lett 32: 391, 2026.
APA
Lou, Y., & Fan, Y. (2026). Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review). Oncology Letters, 32, 391. https://doi.org/10.3892/ol.2026.15746
MLA
Lou, Y., Fan, Y."Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review)". Oncology Letters 32.3 (2026): 391.
Chicago
Lou, Y., Fan, Y."Microbiota in pancreatic cancer: Roles in tumor initiation and progression (Review)". Oncology Letters 32, no. 3 (2026): 391. https://doi.org/10.3892/ol.2026.15746
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