HR+、HER2-早期浸润性乳腺癌中多基因检测的应用及进展

Application and progress ofdifferent biomarkers in HR+and HER2-early invasive breast cancer

临床上激素受体(HR)阳性乳腺癌患者治疗方案的制定通常基于病理学的各项指标。然而,一些临床特征相似的患者在接受相同的治疗后,疗效和预后有很大差异,这提示经典的临床病理学特点可能不足以用来制定乳腺癌综合治疗策略。该文研究早期浸润性乳腺癌中HR阳性、人表皮生长因子受体2(HER2)阴性的人群,对3种常见的基因检测手段21基因复发评分(OncotypeDX)、70基因(MammaPrint)和PAM50(Prosigna)的临床有效性和实用性进行系统的综述。3种检测方式均能区分预后差异,可用于HR+、HER2-、淋巴结未受累的早期乳腺癌患者的全身治疗指导,MammaPrint还可用于1~3枚淋巴结受累的患者。Prosigna具有长期预后能力,或可用于筛选能从延长内分泌治疗中获益的人群。

The formulation of treatment for hormone receptor(HR)-positive breast cancer patients is usually based on clinical pathological indicators.However,some patients with similar clinical characteristics have great differences in efficacy and prognosis after receiving the same treatment,which suggests that the classic clinical pathological characteristics may not be sufficient to formulate comprehensive treatment strategies for breast cancer.The clinical effectiveness of three common genetic testing methods including OncotypeDX,MammaPrint and PAM50 on the patients of HR-positive and human epidermal growth factor receptor 2(human epidermal growth factor receptor 2,HER2)negative in early invasive breast cancer will be reviewed in this article.All the three methods can be used to distinguish prognostic differences for early breast cancer patients with HR+,HER2-and negative lymph node.MammaPrint can also be used in patients with 1-3 lymph nodes involvement.Prosigna has long-term prognostic ability,and may be used to screen people who benefits from extended endocrine therapy.