ArticleBMC cancer2024
The Concept of Stroma AReactive Invasion Front Areas (SARIFA) as a new prognostic biomarker for lipid-driven cancers holds true in pancreatic ductal adenocarcinoma.
Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Direct tumour-adipocyte contact / Stroma AReactive Invasion Front Area (TAC/SARIFA) predicts adverse outcome in colorectal cancer: a focused evidence synthesis and meta-analysis.Histopathology · 2026Pooled it
- The Association of SARIFA with Poor Prognosis and Aggressive Tumor Phenotypes in Cancers: A Meta-Analysis.Journal of clinical medicine · 2026Review
- Cancer-associated adipocytes: metabolic reprogramming, crosstalk and therapeutic implications in tumor progression.Signal transduction and targeted therapy · 2026Review
- SARIFA and Lipid Metabolic Reprogramming in Prostate Cancer: Fundamental Mechanisms, Tumor Microenvironment, and Novel Biomarker Prospects.Life (Basel, Switzerland) · 2026Review
- Distinct NK cell dynamics in SARIFA positive colorectal cancer patients indicate persistent patient-intrinsic immune signatures after tumor resection.Scientific reports · 2026Article
- [SARIFA: Literature review and expert opinion on the new morphological biomarker].Pathologie (Heidelberg, Germany) · 2026Review
- <p>Unveiling sex differences in pancreatic ductal adenocarcinoma: Current evidence and future directions (Review)</p>.International journal of oncology · 2026Review
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- Stroma areactive invasion front areas (SARIFA) in 1,298 pT3/pT4 colorectal cancers: A strong prognostic parameter complementing established morphological criteria.Histopathology · 2025Article
- Stroma AReactive Invasion Front Areas (SARIFA) and the tumour immune microenvironment in colorectal cancer.British journal of cancer · 2025Article
- [SARIFA-a new multi-entity biomarker].Pathologie (Heidelberg, Germany) · 2024Review
- Converging deep learning and human-observed tumor-adipocyte interaction as a biomarker in colorectal cancer.Communications medicine · 2024Article
- The SARIFA biomarker in the context of basic research of lipid-driven cancers.NPJ precision oncology · 2024Review
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8 authors.
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Abstract
backgroundPancreatic ductal adenocarcinoma (PDAC) is a 'difficult-to-treat' entity. To forecast its prognosis, we introduced a new biomarker, SARIFA (stroma areactive invasion front areas), which are areas at the tumour invasion front lacking desmoplastic stroma reaction upon malignant invasion in the surrounding tissue, leading to direct contact between tumour cells and adipocytes. SARIFA showed its significance in gastric and colorectal carcinoma, revealing lipid metabolism alternations that promote tumour progression.
methodsWe reviewed the SARIFA status of 166 PDAC cases on all available H&E-stained tumour slides from archival Whipple-resection specimens. SARIFA positivity was defined as SARIFA detection in at least 66% of the available slides. To investigate alterations in tumour metabolism and microenvironment, we performed immunohistochemical staining for FABP4, CD36 and CD68. To verify and quantify a supposed delipidation of adipocytes, adipose tissue was digitally morphometrised.
resultsIn total, 53 cases (32%) were classified as SARIFA positive and 113 (68%) as SARIFA negative. Patients with SARIFA-positive PDAC showed a significantly worse overall survival compared with SARIFA-negative cases (median overall survival: 11.0 months vs. 22.0 months, HR: 1.570 (1.082-2.278), 95% CI, p = 0.018), which was independent from other prognostic markers (p = 0.014). At the invasion front of SARIFA-positive PDAC, we observed significantly higher expression of FABP4 (p < 0.0001) and higher concentrations of CD68
conclusionsSARIFA is a promising prognostic biomarker for PDAC. Its assessment is characterised by simplicity and low effort. The mechanisms behind SARIFA suggest a tumour-promoting increased lipid metabolism and altered immune background, both showing new therapeutic avenues.
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