Deshmukh Sachin Kumar, Srivastava Sanjeev K, Tyagi Nikhil, Ahmad Aamir, Singh Ajay P, Ghadhban Ahmed A L, Dyess Donna L, Carter James E, Dugger Kari, Singh Seema
Department of Oncologic Sciences, Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA.
Division of Cell Biology and Genetics, Tatva Biosciences, Coastal Innovation Hub, 600 Clinic Drive, 3rd Floor, Mobile, AL 36688, USA.
Carcinogenesis. 2017 Aug 1;38(8):757-765. doi: 10.1093/carcin/bgx037.
Although increased awareness leading to early detection and prevention, as well as advancements in treatment strategies, have resulted in superior clinical outcomes, African American women with breast cancer continue to have greater mortality rates, compared to Caucasian American counterparts. Moreover, African American women are more likely to have breast cancer at a younger age and be diagnosed with aggressive tumor sub-types. Such racial disparities can be attributed to socioeconomic differences, but it is increasingly being recognized that these disparities may indeed be due to certain genetic and other non-genetic biological differences. Tumor microenvironment, which provides a favorable niche for the growth of tumor cells, is comprised of several types of stromal cells and the various proteins secreted as a consequence of bi-directional tumor-stromal cross-talk. Emerging evidence suggests inherent biological differences in the tumor microenvironment of breast cancer patients from different racial backgrounds. Tumor microenvironment components, affected by the genetic make-up of the tumor cells as well as other non-tumor-associated factors, may also render patients more susceptible to the development of aggressive tumors and faster progression of disease resulting in early onset, thus adversely affecting patients' survival. This review provides an overview of breast cancer racial disparity and discusses the existence of race-associated differential tumor microenvironment and its underlying genetic and non-genetic causal factors. A better understanding of these aspects would help further research on effective cancer management and improved approaches for reducing the racial disparities gaps in breast cancer patients.
尽管意识的提高带来了早期发现和预防，以及治疗策略的进步，从而产生了更好的临床结果，但与美国白人女性相比，患有乳腺癌的非裔美国女性的死亡率仍然更高。此外，非裔美国女性更有可能在年轻时患乳腺癌，并被诊断为侵袭性肿瘤亚型。这种种族差异可归因于社会经济差异，但人们越来越认识到，这些差异可能确实是由于某些基因和其他非基因生物学差异造成的。肿瘤微环境为肿瘤细胞的生长提供了有利的生态位，它由几种类型的基质细胞以及肿瘤与基质双向相互作用分泌的各种蛋白质组成。新出现的证据表明，来自不同种族背景的乳腺癌患者的肿瘤微环境存在内在生物学差异。肿瘤微环境成分受肿瘤细胞的基因组成以及其他与肿瘤无关的因素影响，也可能使患者更容易患侵袭性肿瘤，并导致疾病进展更快，从而过早发病，进而对患者的生存产生不利影响。本综述概述了乳腺癌的种族差异，并讨论了与种族相关的肿瘤微环境差异的存在及其潜在的基因和非基因因果因素。更好地理解这些方面将有助于进一步研究有效的癌症管理以及减少乳腺癌患者种族差异差距的改进方法。
