ER、PR、HER-2均阴性乳腺癌人群的研究进展

Research progress in triple-negative breast cancer

ER、PR和HER-2均为阴性的乳腺癌(三阴乳腺癌)患者是一组特殊的群体,其病理及肿瘤生物学特征有:多为导管癌、组织学分级较高、肿瘤细胞多表达basal细胞角蛋白、EGFR和p53等,并且在表型特征和分子水平上与basal-like乳腺癌和BRCA1相关乳腺癌存在一定的相关性。三阴乳腺癌患者常较早发生局部复发和远处转移,内脏转移率高于骨转移,预后较差,近来研究者开始逐渐重视此亚型群体。由于没有内分泌和靶向HER-2治疗的机会,因此只能将化疗作为主要的治疗手段,目前也有一些关于化疗和靶向治疗等方面的研究报道和临床试验,提示烷化剂、铂类、蒽环类等可能是相对敏感药物,针对EGFR、C-kit和Src等靶点的靶向治疗也有可能发挥较好的治疗效果。但是目前的研究结果还不能明确三阴乳腺癌的生物学特点和最佳治疗策略,本文将有关三阴乳腺癌的最新进展做一综述。

＂Triple - negative＂ breast cancer patient is defined by a lack expression of oestrogen, progesterone, and HER -2 receptors . The pathological characteristics include： mostly ductal carcinoma; high histologic grade; basal cytokeratin expression; EGFR and p53, etc. And it may have relationship with Basal-like breast cancer and BRCA1 - related breast cancer on the phenotype and molecule level. Triple - negative patients usually relapse and metastasize early with worse prognosis, and have a higher incidence of visceral metastases than bony metastases. This subgroup has no chance of hormone treatment and targeted therapy for HER -2, and chemotherapy is the mainstay therapy. Some basic studies and clinical trials of chemotherapy and targeted treatment suggested triple-negative cancer might show sensitivity to alkylating agent, platinum drugs and anthracycline-based chemotherapy. Furthermore, targeted therapy against EGFR, C - kit, and Src may show preferable anticancer activity. However, recent research still failled to identify the biological characteristics of triple - negative mammary cancer, and special treatment guidelines are still not available.