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乳腺癌是一类高度异质性的肿瘤,包括18种组织病理学类型和5种分子亚型。乳腺癌干细胞(CSCs)是乳腺癌组织中极少数具有自我更新能力和多向分化潜能的细胞,具有肿瘤启动作用。CD44~+/cD24~(-/low)表型为乳腺CSCs的标志,大约30%乳腺癌组织中存在CD44~+/cD24~(-/low)表型细胞,CD44~+/CD24~(-/low)表型细胞与病理组织学类型有关,在呈现CD44~+/CD24~(-/low)表型的肿瘤中,浸润性导管癌所占比例最多(78%),其次为髓样癌(11%)和浸润性小叶癌(7%)。CD44~+/CD24~(-/low)表型细胞与乳腺癌的分子亚型有关,在依据基因表达谱得到的5种分子亚型中,CD44~+/CD24~(-/low)表型在基底样癌中最常见。乳腺癌干细胞通常为ER-和PR-的表型,但ER-和PR-的多潜能干细胞能产生ER+,PR+的肿瘤细胞。HER2过表达能够增加CSCs的数量并促进乳腺癌的发生、进展和浸润,但乳腺癌组织中CD44~+/CD24~(-/low)表型通常与HER2低表达或阴性表达呈正相关。迄今有关干细胞与乳腺癌的临床基础研究提出了更多新的问题,引发了更多的思考。
Breast cancer is a highly heterogeneous group of tumors that includes 18 histopathological types and 5 molecular subtypes. Breast cancer stem cells (CSCs) are very few cells with self-renewal ability and multidirectional differentiation potential in breast cancer tissues, which have the function of tumor initiation. CD44 ~ + / cD24 ~ (- / low) phenotype is a marker of breast CSCs. CD44 + / CD24 ~ (-) low phenotype cells are present in about 30% of breast cancer tissues, / low) phenotype cells were associated with histopathological types. Of the tumors with the CD44 + / CD24 ~ (- / low) phenotype, the most common type was invasive ductal carcinoma (78%), followed by medullary carcinoma (11%) and invasive lobular carcinoma (7%). The CD44 ~ + / CD24 ~ (- / low) phenotype cells are related to the molecular subtypes of breast cancer. Among the five molecular subtypes based on the gene expression profile, the CD44 ~ + / CD24 ~ In basal-like carcinomas, the most common. Breast cancer stem cells are typically ER- and PR- phenotypes, but ER- and PR- pluripotent stem cells can produce ER +, PR + tumor cells. HER2 overexpression can increase the number of CSCs and promote the occurrence, progression and infiltration of breast cancer. However, the expression of CD44 ~ + / CD24 ~ (- / low) in breast cancer tissues is usually positively correlated with the low or negative expression of HER2. So far, the basic clinical research on stem cells and breast cancer has raised more new questions and triggered more thinking.