Michel Rosa M, Aguilar José Luis, Arrieta Oscar
Department of Medical Oncology, Instituto Nacional de Cancerología, Av. San Fernando, No. 22, Col. Sección XVI, Tlalpan 14080, Mexico City, Mexico.
Med Hypotheses. 2007;68(5):1035-40. doi: 10.1016/j.mehy.2006.05.072. Epub 2006 Nov 16.
Breast cancer associated with pregnancy is defined as the one in which the diagnosis is made in a pregnancy or within one year of delivery. Breast cancer is the second most common malignancy during pregnancy and it is generally considered to have a worse prognosis than the one that is not associated with pregnancy. The average patient is between 32 and 38 years of age. Steroid hormone receptor-positive cell populations comprise 80% of breast cancers, however, estrogen receptor levels in pregnancy-associated tumors are often low or absent. Extensive laboratory data suggest that angiogenesis plays an essential role in breast cancer development, invasion, and metastasis. One of the most powerful stimulatory factors, vascular endothelial growth factor (VEGF), functions in autocrine/paracrine pathways. Current research, generally has validated the poor prognosis and early relapse that are associated with increasing microvessel density, which is related to VEGF expression in tumoral cells. During pregnancy, human chorionic gonadotropin (hCG) induces neovascularization in various tissues, one of them being the placenta. Its receptors have been detected in epithelial cells in breast carcinoma tissue, and breast cancer cell lines. According to this premise the hCG normally produced during pregnancy could induce the synthesis of VEGF and by this means stimulate the development and metastatic potential of breast cancer cells in the pregnancy period. Thus, research involving hCG and VEGF would help us understand the physiopathology of breast cancer during pregnancy, as well as provide us with probable prognostic tools.
妊娠相关乳腺癌被定义为在孕期或分娩后一年内确诊的乳腺癌。乳腺癌是孕期第二常见的恶性肿瘤，一般认为其预后比非妊娠相关乳腺癌更差。患者平均年龄在32至38岁之间。类固醇激素受体阳性细胞群占乳腺癌的80%，然而，妊娠相关肿瘤中的雌激素受体水平往往较低或缺失。大量实验室数据表明，血管生成在乳腺癌的发生、侵袭和转移中起重要作用。最强大的刺激因子之一血管内皮生长因子（VEGF）通过自分泌/旁分泌途径发挥作用。目前的研究普遍证实，微血管密度增加与预后不良和早期复发相关，而微血管密度增加与肿瘤细胞中的VEGF表达有关。在孕期，人绒毛膜促性腺激素（hCG）可诱导多种组织（包括胎盘）的新生血管形成。在乳腺癌组织的上皮细胞以及乳腺癌细胞系中已检测到其受体。基于这一前提，孕期正常产生的hCG可能诱导VEGF的合成，进而刺激孕期乳腺癌细胞的生长和转移潜能。因此，涉及hCG和VEGF的研究将有助于我们了解孕期乳腺癌的病理生理学，并为我们提供可能的预后工具。
