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目的 TAM(tamoxifen,TAM)仍然是早期雌激素受体(estrogen receptor,ER)阳性乳腺癌患者术后辅助性内分泌治疗的基本药物。但TAM的耐药严重影响患者的预后,因此,寻找能够准确预测TAM耐药的因子非常重要。TAM体内代谢酶CYP450(细胞色素P450)酶家族基因存在大量单核苷酸多态性(single nucleotide poly-morphism,SNP),某些类型SNP基因型确定的表型(IM/PM)导致酶活性降低或失去,患者体内TAM活性型代谢产物浓度降低,患者预后较差。因此,CYP450SNP基因型可以作为预测TAM耐药的候选因子。在我国TAM仍然是雌激素受体阳性乳腺癌患者辅助内分泌治疗的主要一线药物,但此方面研究相对较少,应该引起关注。
Objective TAM (tamoxifen, TAM) is still the primary drug for postoperative adjuvant endocrine therapy in patients with early-stage estrogen receptor (ER) -positive breast cancer. However, the drug resistance of TAM seriously affects the prognosis of patients, therefore, it is very important to find a factor that can accurately predict TAM resistance. There are a large number of single nucleotide polymorphisms (SNPs) in the CYP450 (cytochrome P450) enzyme family gene in TAM, and the phenotype (IM / PM) of some SNP genotypes leads to enzyme activity Reduce or lose, the patient’s TAM active metabolite concentration decreased, the patient’s prognosis is poor. Therefore, the CYP450 SNP genotype can be used as a candidate for predicting TAM resistance. TAM in our country is still the main first-line drug for adjuvant endocrine therapy in patients with estrogen receptor positive breast cancer, but relatively few studies in this area should cause concern.