肿瘤干细胞在三阴性乳腺癌治疗耐药中的作用及机制研究进展

三阴性乳腺癌（TNBC）是雌激素受体（ER）、孕激素受体（PR）、人类表皮生长因子受体2（HER-2）蛋白均呈阴性的临床亚型，占所有乳腺癌病例的15%~20%。与其他亚型相比，TNBC更具侵袭性，其预后差、复发转移率和病死率高。一直以来，TNBC的治疗面临着巨大的挑战，由于治疗靶点的缺乏，细胞毒性化疗是唯一被批准用于TNBC的全身治疗方案。为了改善TNBC患者的疗效，研究者们开展了大量的临床试验来探索更多有效的治疗手段。乳腺癌干细胞（BCSC）的自我更新分化是乳腺癌发生发展的重要机制，能够调控乳腺癌的侵袭转移和治疗抵抗，TNBC中肿瘤干细胞（CSC）比例的升高与化疗耐药和不良预后相关。本综述阐述了TNBC的治疗现状以及CSC在TNBC的发生发展、治疗耐药中的作用机制，探讨了CSC及相关信号因子作为TNBC治疗靶点的潜在价值。

Research progress of role and mechanism of tumor stem cells in drug resistance of triple negative breast cancer

Triple negative breast cancer(TNBC)is a clinical subtype with negative estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2)protein,accounting for 15%~20% of all breast cancer cases.Compared with other subtypes,TNBC is more aggressive,with poor prognosis,high recurrence and metastasis rate and mortality.The treatment of TNBC has always faced great challenges.Due to the lack of therapeutic targets,cytotoxic chemotherapy is the only systemic therapy approved for TNBC.In order to improve the efficacy of patients with TNBC,researchers conducted a large number of clinical trials to explore more effective treatment methods.Self-renewal differentiation of breast cancer stem cells(BCSC)is an important mechanism of the occurrence and development of breast cancer,and can regulate the invasion,metastasis and treatment resistance of breast cancer.The increase in the proportion of CSC in TNBC is related to chemotherapy resistance and poor prognosis.This review describes the current treatment status of TNBC and the mechanism of CSC in the occurrence,development and treatment of TNBC resistance,and discusses the potential value of CSC and related signal factors as TNBC therapeutic targets.