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探索乳腺癌的生物标志物:临床实践中诊断、治疗和随访的特征。

Exploring Biomarkers in Breast Cancer: Hallmarks of Diagnosis, Treatment, and Follow-Up in Clinical Practice.

机构信息

Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain.

Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain.

出版信息

Medicina (Kaunas). 2024 Jan 17;60(1):168. doi: 10.3390/medicina60010168.

Abstract

Breast cancer is a prevalent malignancy in the present day, particularly affecting women as one of the most common forms of cancer. A significant portion of patients initially present with localized disease, for which curative treatments are pursued. Conversely, another substantial segment is diagnosed with metastatic disease, which has a worse prognosis. Recent years have witnessed a profound transformation in the prognosis for this latter group, primarily due to the discovery of various biomarkers and the emergence of targeted therapies. These biomarkers, encompassing serological, histological, and genetic indicators, have demonstrated their value across multiple aspects of breast cancer management. They play crucial roles in initial diagnosis, aiding in the detection of relapses during follow-up, guiding the application of targeted treatments, and offering valuable insights for prognostic stratification, especially for highly aggressive tumor types. Molecular markers have now become the keystone of metastatic breast cancer diagnosis, given the diverse array of chemotherapy options and treatment modalities available. These markers signify a transformative shift in the arsenal of therapeutic options against breast cancer. Their diagnostic precision enables the categorization of tumors with elevated risks of recurrence, increased aggressiveness, and heightened mortality. Furthermore, the existence of therapies tailored to target specific molecular anomalies triggers a cascade of changes in tumor behavior. Therefore, the primary objective of this article is to offer a comprehensive review of the clinical, diagnostic, prognostic, and therapeutic utility of the principal biomarkers currently in use, as well as of their clinical impact on metastatic breast cancer. In doing so, our goal is to contribute to a more profound comprehension of this complex disease and, ultimately, to enhance patient outcomes through more precise and effective treatment strategies.

摘要

乳腺癌是当今一种普遍的恶性肿瘤,尤其影响女性,是最常见的癌症之一。相当一部分患者最初表现为局部疾病,可采用治愈性治疗。相反,另一大部分患者被诊断为转移性疾病,其预后较差。近年来,由于发现了各种生物标志物和出现了靶向治疗,后者的预后发生了深刻的变化。这些生物标志物包括血清学、组织学和遗传学指标,已在乳腺癌管理的多个方面证明了其价值。它们在初始诊断中起着至关重要的作用,有助于在随访期间发现复发,指导靶向治疗的应用,并为预后分层提供有价值的见解,尤其是对于高度侵袭性的肿瘤类型。鉴于目前有多种化疗选择和治疗方式,分子标志物现已成为转移性乳腺癌诊断的基石。这些标志物标志着针对乳腺癌治疗选择的变革性转变。它们的诊断精度使我们能够对具有高复发风险、更高侵袭性和更高死亡率的肿瘤进行分类。此外,针对特定分子异常的靶向治疗的存在引发了肿瘤行为的一系列变化。因此,本文的主要目的是全面回顾目前使用的主要生物标志物的临床、诊断、预后和治疗效用,以及它们对转移性乳腺癌的临床影响。通过这样做,我们的目标是帮助更深入地了解这种复杂的疾病,并最终通过更精确和有效的治疗策略来改善患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66dd/10819101/530f32ecb19b/medicina-60-00168-g001.jpg

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