综述:用于预测乳腺癌复发的(生物)标志物
Scoping review: (Bio)markers for the prognostication of breast cancer recurrence.
作者信息
Sallauka Rigon, Horvat Matej, Ravnik Maja, Rashwan Hatem, Arioz Umut, Mlakar Izidor
机构信息
HUMADEX Group, Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia.
Oncology Department, University Medical Center Maribor, Maribor, Slovenia.
出版信息
BMC Cancer. 2025 Jul 1;25(1):1081. doi: 10.1186/s12885-025-14515-z.
BACKGROUND
The aim of this study is to gain a comprehensive understanding of the latest advancements in breast cancer recurrence markers, with the aim of identifying minimally invasive or minimally intrusive markers as necessary approach for screening for breast cancer recurrence.
METHODS
We followed PRISMA guidelines, systematically searching Web of Science, Scopus, and PubMed from 2010 to December 2023 for secondary papers on breast cancer markers of recurrence. Keywords used to search the databases include but are not limited to: "breast cancer recurrence", "markers", "radiology", "pathology", "clinical features". Studies focusing solely on outcomes after recurrence, such as survival or treatment response, were excluded to ensure the review targeted markers relevant to early prediction. The search was limited to English language. Selected papers underwent screening process according to inclusion/exclusion criteria, and data extraction included publication details, markers, marker modality, among others.
RESULTS
The number of papers considered for this review was 1,138. After two phases of screening process, a total number of 28 reviews were included in this scoping review. We have categorized markers into radiological, clinical, and histopathological types. Among the most relevant clinical markers correlated with breast cancer (BC) recurrence are clinical stage, carcinoembryogenic antigen (CEA), and cancer antigen 15.3 (CA 15.3). We have also identified that the following radiological markers are the most mentioned markers associated with recurrence: mammographic density (MD), tumor heterogeneity, most enhancing tumor volume (METV), radiomic features, and more. Furthermore, we identified nuclear grade, microenvironment heterogeneity, estrogen receptor (ER), androgen receptor (AR), human epidermal growth factor receptor 2 (HER2), Ki-67 antigen, as the most significant histopathological markers of breast cancer recurrence.
CONCLUSION
This review identified promising markers for breast cancer recurrence in three categories: clinical, radiological and histopathological. General practitioners can leverage these insights for enhanced pre-screening, aiding in earlier detection and intervention, thus improving patient outcomes. Unclear cut-off values and disagreement on their use remain obstacles.
背景
本研究旨在全面了解乳腺癌复发标志物的最新进展,以便确定微创或微侵入性标志物作为筛查乳腺癌复发的必要手段。
方法
我们遵循PRISMA指南,系统检索了2010年至2023年12月期间Web of Science、Scopus和PubMed上关于乳腺癌复发标志物的二次文献。用于检索数据库的关键词包括但不限于:“乳腺癌复发”、“标志物”、“放射学”、“病理学”、“临床特征”。仅关注复发后结果(如生存或治疗反应)的研究被排除,以确保综述针对与早期预测相关的标志物。检索限于英文文献。所选论文根据纳入/排除标准进行筛选过程,数据提取包括发表细节、标志物、标志物类型等。
结果
本次综述考虑的论文数量为1138篇。经过两个阶段的筛选过程,本范围综述共纳入28篇综述。我们将标志物分为放射学、临床和组织病理学类型。与乳腺癌(BC)复发相关的最相关临床标志物包括临床分期、癌胚抗原(CEA)和癌抗原15.3(CA 15.3)。我们还确定以下放射学标志物是与复发相关的最常提及的标志物:乳腺X线密度(MD)、肿瘤异质性、最大强化肿瘤体积(METV)、影像组学特征等。此外,我们确定核分级、微环境异质性、雌激素受体(ER)、雄激素受体(AR)、人表皮生长因子受体2(HER2)、Ki-67抗原是乳腺癌复发最重要的组织病理学标志物。
结论
本综述确定了临床、放射学和组织病理学三类有前景的乳腺癌复发标志物。全科医生可以利用这些见解加强预筛查,有助于早期发现和干预,从而改善患者预后。临界值不明确以及对其使用存在分歧仍然是障碍。