基于文献分析的精准乳腺癌个体化医疗进展研究

目的　根据近5年乳腺癌精准医学和个体化医学相关文献，分析其国内外研究进展，探究个体化医疗的现状和未来的发展方向，构建以患者为中心的乳腺癌个体化医疗方案。方法　抽取万方医学网（限定中国科技核心期刊）和Web of Science 两个数据库中的乳腺癌精准相关文献，对其进行统计分析，从年发文趋势、国家、研究机构、国内外热门研究领域与高频关键词分布等角度入手。结果　共检索到精准医学相关中文文献3 336篇，英文文献20 241篇，近5年乳腺癌在精准医学方面的文献呈总体上升趋势；发文量最大的国家为美国（30.4％），其次是中国（24.0％）；国内高发文机构为中国科学院系统（295 篇／1.415％）；研究热点主要表现为通过液体活检和新一代基因测序实现精确诊断，通过靶向用药、精准外科和免疫治疗实现精确治疗。精准医疗更重视“病”的深度特征和“药”的高度精确性，形成高水平医疗技术。结论　精准医学是实现个体化医学的基础和必须条件。乳腺癌精准医学的研究以实现个体化医学为目标，以基因测序和靶向药物为基础，结合遗传因素、环境因素、药物反应个体差异，并考虑年轻乳腺癌保乳治疗等复杂议题，因此现代个体化医学应当逐渐形成以患者为中心，了解自身基因，针对性改善外部环境，从而形成个体化治疗和用药的医疗模式，进而预防疾病发生，提高生活质量。但是目前的个体化医学仍面临严峻的挑战，需要我们共同的努力。

Research progress of precision individualized medical treatment of breast cancer based on literature analysis

Objective:Toanalyzethedomesticandforeignresearchprogressofprecisionmedicineandindividualizedmedicineofbreastcancerinrecentfiveyears,explorethecurrentsituationandfuturedevelopmentdirectionofindividualizedmedicine,andconstructapatient-centeredindividualizedmedicalplanforbreastcancer. Methods:TheaccuraterelatedliteraturesofbreastcancerinthedatabasesofWanfangmedicalnetworkandWebofSciencewereextractedandstatisticallyanalyzedfromtheperspectivesofannualpublicationtrends,countries,researchinstitutions,hotresearchfieldsathomeandabroadandthedistributionofhigh-frequencykeywords. Results:Atotalof3,336Chineseand20,241Englishliteraturesrelatedtoprecisionmedicinewereretrieved.Inthepastfiveyears,theliteratureonprecisionmedicineofbreastcancershowedanoverallrisingtrend.ThecountrywiththelargestnumberofpublicationsistheUnitedStates(30.4%),followedbyChina(24.0%).Chineseacademyofsciences(295articles/1.415%);Theresearchfocusesonaccuratediagnosisthroughliquidbiopsyandnext-generationgenesequencing,andprecisetreatmentthroughtargeteddrugs,precisionsurgeryandimmunotherapy.Precisionmedicinepaysmoreattentiontothedepthof"disease"andthehighaccuracyof"medicine",formingahigh-levelmedicaltechnology. Conclusion:Precisionmedicineisthebasisandnecessaryconditionofindividualizedmedicine.Precisionmedicalresearchofbreastcancerinordertorealizeindividualizedmedicineasthegoal,onthebasisofgenesequencingandtargeteddrugs,incombinationwithgeneticfactors,environmentalfactors,drugreactionindividualdifferences,andtoconsideryoungcomplexissues,suchasbreastcancerconfirmedbreast,somodernindividualizedmedicineshouldbegraduallyformedtakingpatientsasthecenter,tounderstandtheirowngenes,targetedtoimprovetheexternalenvironment,thusformingindividualizeddrugtherapyandmedicalmodel,andpreventionofdisease,improvethequalityoflife.However,thecurrentpersonalizedmedicinestillfacesseverechallenges,whichrequireourjointefforts.