乳腺癌21基因检测的研究进展

乳腺癌是一类具有异质性的肿瘤,不同患者的治疗方法和疗效都不相同。尽管目前仍在努力为激素受体（hormone receptor,HR）阳性（+）、人表皮生长因子受体2（human epidermal growth factor receptor 2,HER-2）阴性（-）、淋巴结（axillary lymph node,ALN）阴性（-）的早期乳腺癌患者寻找合适的治疗方法,但其术后是否需要化疗仍然是肿瘤科医生面临的一个难题。以往治疗主要依赖于经典的组织病理学和免疫组织化学技术,随着精准医疗时代的到来,我们需要更定量的诊断方法和合理的个体化治疗。虽然化疗可降低疾病复发风险并提高生存率,但它带来的不良反应事件会降低患者的生活质量,尤其低复发风险（recurrence risk,RS)有可能超过化疗益处。21基因检测不仅可以预测这类早期乳腺癌化疗疗效及评估预后,还可提供精准的个体化治疗方案指导用药,为患者增添信心。本文就乳腺癌21基因检测的研究进展进行综述。

Research progress of 21-genes in breast cancer

Breast cancer is a heterogeneous type of tumor,and different patients have different treatment methods and curative effects.Although efforts are still being made to find appropriate treatments for patients with early stage breast cancer who are hormone receptor (HR) positive (+),human epidermal growth factor receptor 2 (HER-2) negative (-) and axillary lymph node (ALN) negative (-),but the need for chemotherapy after surgery remains a problem for oncologists.In the past,treatment still relied mainly on classic histopathology and immunohistochemistry.With the advent of the era of precision medicine,we need more quantitative diagnostic methods and reasonable individualized treatment.Although chemotherapy can reduce the risk of disease recurrence and improve survival,its adverse events (especially low RS) can reduce the quality of life of patients and may exceed the benefits of chemotherapy.The 21-gene assay can not only predict the efficacy and prognosis of chemotherapy,but also provide individualized treatment schemes to increase patient confidence.This article reviews the research progress of 21-gene assay.