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目的三阴性乳腺癌(triple negative breast cancer,TNBC)作为乳腺癌的一种特殊类型,具有高侵袭性,极易出现局部复发和远处转移。近年来关于TNBC进一步亚分类,并且针对各亚型进行相应靶向治疗的基础研究和临床研究均较多。本研究对国内外TNBC的分子分型和个体化治疗新进展进行综述分析。对国内外三阴性乳腺癌(triple negative breast cancer,TNBC)的分子分型以及个体化治疗新进展进行综述分析。方法应用PubMed及CNKI期刊全文数据库检索系统,以“三阴性乳腺癌、TNBC、分子分型、治疗”等为关键词,检索2011-01-2016-05相关文献,共检索到英文文献240条,中文文献449条。纳入标准:(1)TNBC的生物学功能;(2)TNBC的分子分型;(3)TNBC的个体化治疗。剔除标准:(1)乳腺癌的分子分型;(2)乳腺癌的个体化治疗。根据剔除标准剔除中文文献130条,英文文献141条,最后纳入分析63篇文献。结果 TNBC从基因学角度分为6个亚型,针对每个亚型均有不同的个体化治疗靶向药物,包括表皮生长因子受体(epidermal growth factor receptor,EGFR)抑制剂、铂类、聚腺苷酸二磷酸核糖转移酶(poly-AD-ribose polymerase,PARP)抑制剂、蒽环/紫衫、免疫治疗、血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)抑制剂、雄激素受体(androgen receptor,AR)拮抗剂以及各靶向治疗手段的联合使用。结论 TNBC是异质性疾病,其分子分型的确定对于理解肿瘤的生物学特征和临床行为,以及发展TNBC个体化治疗都是必需的。由于TNBC肿瘤信号通路之间的交联,发展不同靶向药物的联合应用才有望真正的提高该疾病的总生存。
Objective Triple negative breast cancer (TNBC), as a special type of breast cancer, is highly aggressive and prone to local recurrence and distant metastasis. In recent years, there have been more basic and clinical researches on the further sub-classification of TNBC and the corresponding targeted therapy for each subtype. This study summarizes the recent progress of molecular typing and individualized treatment of TNBC at home and abroad. The molecular typing of triple negative breast cancer (TNBC) at home and abroad and the new progress of individualized therapy were reviewed. Methods PubMed and CNKI journal full-text database search system was used to search for articles related to “triple negative breast cancer, TNBC, molecular typing, treatment” and so on. The relevant articles were retrieved from 2011-01-2016-05 and 240 English articles were retrieved Article, the Chinese literature 449. Inclusion criteria: (1) Biological function of TNBC; (2) Molecular typing of TNBC; (3) Individualized treatment of TNBC. Exclusion criteria: (1) molecular classification of breast cancer; (2) individualized treatment of breast cancer. Excluding 130 Chinese articles and 141 English articles according to the exclusion criteria, 63 literatures were finally included in the analysis. Results TNBC was divided into six subtypes from the perspective of genomics, and each subtypes had different individualized targeted drugs, including epidermal growth factor receptor (EGFR) inhibitors, platinum, poly Inhibitors of poly-AD-ribose polymerase (PARP), anthracycline / thaliana, immunotherapy, inhibitors of vascular endothelial growth factor receptor (VEGFR), androgen Receptor (androgen receptor antagonists) and the combination of various targeted therapies. Conclusion TNBC is a heterogeneous disease. The determination of its molecular typing is necessary to understand the biological characteristics and clinical behavior of the tumor and to develop personalized TNBC therapy. Due to the cross-linking of TNBC tumor signaling pathways, the development of a combination of different targeted drugs is expected to truly improve the overall survival of the disease.