Carrasco E, Alvarez Pablo J, Prados José, Melguizo Consolación, Rama Ana R, Aránega Antonia, Rodríguez-Serrano Fernando
Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Armilla, Spain; PhD Program in Biomedicine, University of Granada, Granada, Spain.
Eur J Clin Invest. 2014 Jul;44(7):678-87. doi: 10.1111/eci.12276. Epub 2014 May 22.
The cancer stem cell (CSC) hypothesis on the origin of cancer has recently gained considerable support. CSCs are tumour cells with the capacity for self-renewal and differentiation that direct the origin and progression of the disease and may be responsible for relapse, metastasis and treatment failures.
This article reviews breast CSCs (BCSCs) phenotyping, clinical implications and clinical trials focused on BCSCs in breast cancer. Relevant studies were found through PubMed and Clinicaltrials.gov databases.
Cancer stem cells are identified and isolated using membrane and cell activity markers; in the case of BCSCs, these are CD44(+) /CD24(low/-) and show aldehyde dehydrogenase activity, alongside their capacity to grow and form mammospheres. The presence of stem cell properties is associated with a worse outcome. Hence, these cells have important clinical implications, and elucidation of the mechanisms underlying their activity will allow the development of novel effective therapies and diagnostic instruments, improving the prognosis of these patients.
Standard treatments are directed against the tumour mass and do not eliminate CSCs. There is therefore a need for specific anti-CSC therapies, and numerous authors are investigating new targets to this end, as reported in this review. It is also necessary for clinical trials to be undertaken to allow this new knowledge to be applied in the clinical setting. However, there have been few trials on anti-BCSCs therapies to date.
癌症起源的癌症干细胞（CSC）假说最近获得了相当多的支持。癌症干细胞是具有自我更新和分化能力的肿瘤细胞，它们主导疾病的起源和进展，可能是复发、转移及治疗失败的原因。
本文综述了乳腺癌中的癌症干细胞（BCSC）的表型分析、临床意义以及针对BCSC的乳腺癌临床试验。通过PubMed和Clinicaltrials.gov数据库检索相关研究。
利用膜和细胞活性标志物来识别和分离癌症干细胞；就BCSC而言，这些标志物是CD44(+) /CD24(low/-)，并显示醛脱氢酶活性，同时它们具有生长和形成乳腺球的能力。干细胞特性的存在与较差的预后相关。因此，这些细胞具有重要的临床意义，阐明其活性的潜在机制将有助于开发新的有效治疗方法和诊断工具，改善这些患者的预后。
标准治疗针对肿瘤块，无法消除癌症干细胞。因此，需要特定的抗CSC疗法，正如本综述所报道的，众多作者正在为此研究新的靶点。还需要进行临床试验，以便将这些新知识应用于临床。然而，迄今为止针对抗BCSC疗法的试验很少。
