PDX1 in human cancers: Molecular mechanisms, dual roles and clinical implications (Review)

Pancreatic and duodenal homeobox gene 1 (PDX1) is a critical transcription factor involved in pancreatic development and the functionality of mature β‑cells. PDX1 regulates key genes, including insulin and GLUT2, through its DNA‑binding homologous structural domain. In tumors, PDX1 exhibits complex, context‑dependent functions. In pancreatic ductal adenocarcinoma, it transitions from inhibiting follicular cell transformation to promoting tumor proliferation and preventing apoptosis, ultimately inhibiting epithelial‑mesenchymal transition during metastasis. In gastric cancer, PDX1 acts as a tumor suppressor gene, while in esophageal, colorectal, and prostate cancers, it plays a pro‑oncogenic role. Given the dual role of PDX1 in tumorigenesis, its aberrant expression offers potential applications in tumor diagnosis, treatment, and prognosis. The present review explored the structure, function, and mechanisms of PDX1 in tumors, as well as its clinical translational potential, aiming to provide insights for further basic research and pave the way for clinical drug development.