乳腺癌21基因检测的背景与应用

2016-09-16 佚名红中基因

乳腺癌21基因检测技术已经广泛应用于临床。2008年，美国国立综合癌症网络（National ComprehensiveCancer Network，NCCN）乳腺癌治疗指南中建议将21基因复发评分（RS）用于从低危乳腺癌患者中选择需要接受化疗的患者。2011 年瑞士St. Gallen国际乳腺癌大会上，绝大多数与会专家建议将21-基因检测技术（Oncotype DX®) 用于预测激素敏感性肿瘤患

乳腺癌21基因检测技术已经广泛应用于临床。

2008年，美国国立综合癌症网络（National ComprehensiveCancer Network，NCCN）乳腺癌治疗指南中建议将21基因复发评分（RS）用于从低危乳腺癌患者中选择需要接受化疗的患者。2011 年瑞士St. Gallen国际乳腺癌大会上，绝大多数与会专家建议将21-基因检测技术（Oncotype DX®) 用于预测激素敏感性肿瘤患者的化疗反应性。2013年的St. Gallen会议在关于luminal型乳腺癌的共识中，可以用21基因RS技术来找出不适宜化疗人群，该技术不仅可以预测预后，还可以用来预测在内分泌治疗基础上加用化疗的有效性。2015年St.Gallen会议，认为21基因检测不仅能提供1-5年及5年后复发风险，还能预测ER阳性浸润性乳腺癌患者对化疗和内分泌治疗的获益程度。

图1：乳腺癌21基因的组成

临床意义

1、提供个体化化基因检测结果，辅助制定乳腺癌治疗方案

通过检测乳腺肿瘤中21个基因，根据它们之间的相互作用来判断肿瘤特性，从而预测个体化的乳腺肿瘤复发风险以及接受化疗的效益。

2、改善癌症患者管理计划

无论是低复发指数或是高复发指数，乳腺癌21基因检测结果都可以进一步协助拟订个体化的癌症康复计划。

适合人群

21基因检测推荐用于评估临床诊断为雌激素受体阳性（ER+）、淋巴结阴性（N-）的乳腺癌患者的复发风险，预测他莫西芬的疗效，患者在接受他莫西芬治疗后如果疗效显著，可以考虑不再进行额外的辅助化疗。

绝经后，淋巴结阳性、雌激素受体阳性的侵润性乳腺癌患者，也可以通过21基因检测确定化疗获益。

乳腺癌21基因检测结果及判定

检测结果为“复发风险评分”，分值为0-100分。

判读标准：（1）RS<18，复发风险较低，请谨慎选择化疗；（2）18，复发风险为中等，在考虑化疗时必须结合其他临床因素；（3）RS>31，复发风险较高，化疗获益较大。

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2018-02-18 1e145228m78(暂无匿称)

学习了.谢谢作者分享!

0 0
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2018-02-16 1e145228m78(暂无匿称)

学习了.谢谢作者分享!

74 0
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2016-12-31 baoya

#21基因检测#

74 0
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2016-09-20 lhl629

很不错的内容

82 0
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2016-09-19 lhl629

很好的内容，谢谢分享。

78 0
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2016-09-18 1dd8a7c5m95(暂无匿称)

学习了，赞一个！！！

1 0
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2016-09-18 prclancet

老黄历了，分值标准已经改变了。

46 0
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2016-09-17 忠诚向上

好好学习一下

52 0
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2016-09-17 lhl629

很好的内容，继续学习。

61 0
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2016-09-16 doctorJiangchao

继续学习

56 0

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