Publication Name	World Journal of Clinical Oncology
Manuscript ID	125896
DOI	10.5306/wjco.125896
Country	China

Category	Neurosciences
Manuscript Type	Minireviews
Article Title	Autonomic neural reprogramming in pancreatic ductal adenocarcinoma: Putative neurotumoral circuits linking perineural invasion to metastatic progression
Manuscript Source	Invited Manuscript
All Author List	Jia-Hui Xie, Shuai-Yan Wang, Jia-Yi Jiang, Jin-Yao Yang, Tong-Tong Zhang, Zi-Mu Li, Yun Liu, Meng-Jiang Lu, Bin Xu, Guan-Hu Yang and Tian-Cheng Xu
Funding Agency and Grant Number	Funding Agency Grant Number National Natural Science Foundation of China 82305376 the Youth Talent Support Project of the China Acupuncture and Moxibustion Association 2024-2026ZGZJXH-QNRC005 2024 Jiangsu Province Youth Science and Technology Talent Support Project JSTJ-2024-380 Talent Cultivation Program for Young Researchers, Key Laboratory of the Ministry of Education Project zyqt202501 & zyqt202503 Jiangsu Provincial Postgraduate Research Innovation Training Program KYCX24_2210 Faculty Research Grant of Macau University of Science and Technology FRG-26-058-FC
Corresponding Author	Tian-Cheng Xu, Academic Fellow, CEO, Chairman, Head, PhD, Principal Investigator, Professor, Visiting Professor, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, No. 138 Xianlin Road, Nanjing 210023, Jiangsu Province, China. xtc@njucm.edu.cn
Key Words	Pancreatic ductal adenocarcinoma; Perineural invasion; Tumor microenvironment; Cancer neuroscience; Mechanotransduction; Metastasis; Sympathetic nerves; Cancer associated fibroblasts
Core Tip	The pancreatic autonomic nervous system regulates tumor initiation, progression, and metastatic evolution through dynamic bidirectional interactions with cancer cells and the tumor microenvironment. Sympathetic input enhances cancer-associated fibroblast (CAF) activation and extracellular matrix remodeling, whereas activated CAF induce stress and injury-like transcriptional programs in sympathetic neurons, thereby strengthening tumor-supporting neural plasticity. Mechanical signal transduction, such as the activation of the PIEZO1-YAP1 pathway, serves as a key driver of neuroinvasive behavior. Targeting the autonomic-neural-tumor axis represents a promising strategy to suppress perineural invasion and prevent systemic dissemination of pancreatic cancer.
Citation	Xie JH, Wang SY, Jiang JY, Yang JY, Zhang TT, Li ZM, Liu Y, Lu MJ, Xu B, Yang GH, Xu TC. Autonomic neural reprogramming in pancreatic ductal adenocarcinoma: Putative neurotumoral circuits linking perineural invasion to metastatic progression. World J Clin Oncol 2026; In press DOI: https://doi.org/10.5306/wjco.125896
PDF	125896-in-press.pdf

Received	2026-07-22 07:41
Peer-Review Started	2026-07-22 07:42
First Decision by Editorial Office Director
Return for Revision	2026-08-24 12:17
Revised	2026-09-03 07:24
Publication Fee Transferred
Second Decision by Editor	2026-10-28 07:35
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-10-28 10:10
Articles in Press	2026-10-28 10:10
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2218-4333 (online)
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