协和医学杂志

2017, v.8(Z2) 235-238

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AJCC第8版乳腺癌预后分期重大更新及临床意义
Critical Updates and Clinical Significance of the 8th Edition of AJCC Breast Cancer Prognostic Staging System

周斌;辛灵;程元甲;刘倩;徐玲;叶京明;段学宁;刘荫华;
ZHOU Bin;XIN Ling;CHENG Yuan-jia;LIU Qian;XU Ling;YE Jing-ming;DUAN Xue-ning;LIU Yin-hua;Breast Disease Center,Peking University First Hospital;

摘要(Abstract):

随着肿瘤相关研究的深入以及基因检测技术在临床应用水平的进步,肿瘤综合诊治理念已经在细化解剖学分期、精确掌握宏观肿瘤负荷的基础上跨越至分析肿瘤生物学特性、研发靶向治疗药物的新阶段。美国癌症联合会(American Joint Committee on Cancer,AJCC)第8版乳腺癌分期系统专家委员会依据雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)及组织学分级4项生物标志物及多基因检测信息,首次建立了全新的乳腺癌预后分期评价系统。其优先采用预后分期系统进行评价的临床推荐原则,将成为人类与癌症抗争史上重大的革命性事件。癌症分期体系从宏观解剖学到微观病理学,并逐渐加入多基因检测信息,标志着肿瘤治疗从群体治疗到分类治疗的进步,并推动乳腺癌诊治进入个体化时代。
The in-depth study of tumors and the evolution of gene detection techniques in the level of clinical application have promoted the comprehensive treatment of tumors from the age of refining anatomic staging,and precisely evaluating anatomic tumor burden,to the age of analyzing the biological feature,and developing target medicine. The panel of the American Joint Committee on Cancer( AJCC),for the first time,in the 8th edition of breast cancer staging system,built the prognostic staging system based on estrogen receptor( ER),progesterone receptor( PR),human epidermal growth factor receptor-2( HER-2),histologic grade( G),and multi-gene expression panels. The principle that the prognostic staging system is more recommended will be a revolution in the history of the war between human and cancer. The evolution of cancer staging system from anatomic level to micropathologic and multigenetic level shows that the cancer treatment has stepped into classificationbased treatment from population-based treatment. This evolution will promote the arrival of personalized treatment.

关键词(KeyWords): 乳腺癌;AJCC癌症分期系统;预后分期;个体化治疗
breast cancer;AJCC cancer staging system;prognostic staging system;personalized treatment

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基金项目(Foundation): 首都医学发展科研基金资助项目(2009-1011);; 首都临床特色应用研究资助项目(Z131107002213007);; 国家重点研发计划精准医学研究重点专项项目(2016YFC0901300)

作者(Author): 周斌;辛灵;程元甲;刘倩;徐玲;叶京明;段学宁;刘荫华;
ZHOU Bin;XIN Ling;CHENG Yuan-jia;LIU Qian;XU Ling;YE Jing-ming;DUAN Xue-ning;LIU Yin-hua;Breast Disease Center,Peking University First Hospital;

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