中医药干预三阴性乳腺癌相关信号通路研究进展

Research Progress of Traditional Chinese Medicine Intervention on Triple Negative Breast Cancer Related Signaling Pathway

截至2022年,乳腺癌已经成为国内外女性癌症发病率第一的癌症。三阴性乳腺癌(triple negative breast cancer,TNBC)是指经检测荧光原位杂交技术(FISH)或免疫组织化学法检查,孕激素受体(estrogen receptor,ER)、雌激素受体(progesterone receptor,PR)、人表皮生长因子受体-2(human epidermalgrowth factor receptor-2,Her-2)均表达为阴性的乳腺癌。目前西医治疗仍以细胞毒性药物化疗为主,例如蒽环类、白蛋白结合紫杉醇等药物。因其恶性程度较高,具有强烈的侵袭性,5年生存率仍较低,预后较差。翻阅国内外文献发现中医药治疗TNBC疗效确切且作用持久,故探索中医药治疗TNBC的机制已经成为近些年的研究热点。既往研究发现TNBC的形成与β-连环蛋白(Wnt/β-Catenin)、核转录因子κB(nuclear factor-κB,NF-κB)、磷脂酰肌醇3-激酶(phosphatidylinositol3-kinase,PI3K)-蛋白激酶B(protein kinase B,AKT)、刺猬因子(hedgehog,Hh)、Notch、Hippo等多种经典信号转导通路有关。中医药可通过干预以上相关信号通路发挥抑制TNBC细胞的增殖、迁移、侵袭以及上皮间充质转化(epithelial-mesenchymal transition,EMT)的形成,逆转耐药性,促进凋亡等作用,以达到抗肿瘤的目的。以细胞信号通路为基础,对近些年中医药治疗TNBC的国内外研究现状进行总结,旨在为今后深入研究中医药治疗TNBC的提供参考依据,以期为临床治疗TNBC提供新思路。

As of 2022,breast cancer has become the most common cancer among women at home and abroad.Triple negative breast cancer(TNBC)refers to breast cancer with negative expressions of estrogen receptor(ER),progesterone receptor(PR)and human epidermalgrowth factor receptor-2(Her-2)by FISH or immunohistochemistry method.At present,chemotherapy with cytotoxic drugs is still the main treatment in Western medicine,such as anthracyclines and albumin-bound paclitaxel.Because of its high degree of malignancy and strong invasiveness,the 5-year survival rate is still low and the prognosis is poor.Reviewing domestic and foreign literature,it is found that traditional Chinese medicine has definite curative effect and long-lasting effect on TNBC.Therefore,exploring the mechanism of traditional Chinese medicine in the treatment of TNBC has become a research hotspot in recent years.Previous studies have found that the formation of TNBC is related to Wnt/β-Catenin,nuclear factor kappa-B(NF-κB),phosphatidylinositol 3-kinase(PI3K)-protein kinase B(AKT),Hedgehog,Notch,Hippo and other classical signal pathways.Traditional Chinese medicine can inhibit TNBC cell proliferation,migration,invasion,EMT formation,reverse drug resistance,promote apoptosis and other effects by interfering the above related signaling pathways,so as to achieve the purpose of anti-tumor.Based on cell signaling pathways,this paper summarized the domestic and foreign research status of TCM treatment of TNBC in recent years,aiming to provide reference for further study of TCM treatment of TNBC in the future and provide new ideas for clinical treatment of TNBC.