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目前乳腺癌的临床诊疗主要依赖影像学和相对较少的预后/预测指标(如雌激素受体、孕激素受体、HER2等).这些生物标志物主要是基于原发肿瘤病灶的生物学检测,可用于转移或复发的检测指标很少,尤其是在切除肿瘤原发灶后,复发监测很困难.循环cell-free microRNAs(circulating cf-miRNAs,或简称circulating miRNAs)的发现为改变现有乳腺癌临床诊疗模式提供了可能.Cell-free miRNA通过外泌体、微囊或转运蛋白的主动外泌机制,可能在循环miRNA的形成中起着重要作用.Cell-free miRNA特别是circulating miRNA不仅自身可以作为信号分子影响肿瘤细胞和组织微环境,而且还可以与其他信号通路发生交互通讯来调控肿瘤部位新生血管的形成和肿瘤细胞表型的上皮-间质转换,影响乳腺癌的侵袭和转移.本文综述了循环miRNA的特征与分泌机制,特别是乳腺癌相关的循环miRNA参与作为一种液体活检生物标志物在乳腺癌诊断、预后评价和疗效评估的临床意义.
At present, clinical diagnosis and treatment of breast cancer mainly depends on imaging and relatively few prognostic / prognostic indicators (such as estrogen receptor, progesterone receptor, HER2, etc.) These biomarkers are mainly based on the biological detection of primary tumor lesions , Which can be used for the detection of metastasis or relapse is rare, especially in the resection of the primary tumor recurrence monitoring difficult.Circular cell-free microRNAs (circulating cf-miRNAs, or simply called miRNAs) found to change the existing breast Cancer clinical diagnosis and treatment patterns possible.Cell-free miRNA through exosomes, microcapsules or transporters active exocrine mechanism may play an important role in the formation of circulating miRNA.Cell-free miRNA, especially circulating miRNA not only its own It can affect tumor cells and tissue microenvironment as signal molecules, and can also interact with other signaling pathways to regulate the formation of neovasculature in tumor site and the epithelial-mesenchymal transition of tumor cell phenotype, which affects the invasion and metastasis of breast cancer. This review summarizes the features and mechanisms of circulating miRNAs, particularly the involvement of circulating miRNAs associated with breast cancer as a fluid biopsy Chi was in breast cancer diagnosis, prognosis and efficacy evaluation of clinical significance.