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<dc:title xml:lang="fr">Physiopathologie du gène homeotique CDX2 dans le pancréas</dc:title>
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<dc:subject xml:lang="fr">CDX2</dc:subject>
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<dc:subject xml:lang="fr">Métaplasie acino-canalaire</dc:subject>
<dc:subject xml:lang="en">CDX2</dc:subject>
<dc:subject xml:lang="en">Pancreatic adenocarcinoma</dc:subject>
<dc:subject xml:lang="en">Acinar-to-ductal metaplasia</dc:subject>
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<dcterms:abstract xml:lang="fr">Le facteur de transcription homéotique CDX2 est spécifiquement exprimé dans l’intestin dont il maintient l’identité et contrôle l’homéostasie. Il existe cependant une expression ectopique de CDX2 dans des lésions précancéreuses et des adénocarcinomes du pancréas chez l’homme, mais son rôle reste controversé. Ce travail de thèse visait à étudier le rôle de CDX2 dans la physiopathologie pancréatique et particulièrement dans la cancérogenèse pancréatique. A partir de l’étude d’une cohorte de patients opérés d’un adénocarcinome pancréatique, nos résultats montrent que l’expression de CDX2 dans la tumeur est associée à de meilleures survie sans récidive et survie globale. Parallèlement, à l’aide d’un modèle murin transgénique permettant l’expression ectopique de CDX2 dans le pancréas, nos résultats montrent le développement d’une métaplasie acino-canalaire associée à une transdifférenciation intestinale partielle. Dans un contexte génétique de prédisposition au cancer (Apc+/Δ14 ou KRas), aucune évolution néoplasique n’a pu être observée. Globalement, ces résultats montrent l’implication complexe de CDX2 dans la cancérogenèse pancréatique.</dcterms:abstract>
<dcterms:abstract xml:lang="en">The intestine-specific transcription factor CDX2 is required throughout life for intestinal homeostasis and for the maintenance of intestinal identity. In pancreatic ductal adenocarcinoma and pancreatic precancerous lesions, CDX2 expression was described, but results concerning its significance are conflicting.This work aimed to investigate the pathophysiological consequences of the expression of CDX2 in pancreas. Our results show that CDX2 expression in pancreatic adenocarcinoma is associated to a better recurrence-free survival and a better overall survival. The study of the functional consequences of the ectopic expression of CDX2 in the pancreas, using a murine model, shows the development of acinar-to-ductal metaplasia accompanied by incomplete intestinal metaplasia. In a genetic context predisposing to the pancreatic cancer (Apc+/Δ14 ou KRas), these lesions don’t evolve into pancreatic adenocarcinoma.Collectively, these results suggest the complex role of CDX2 in pancreatic carcinogenesis.</dcterms:abstract>
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