目的通过对三阴性乳腺癌(Triple-negative breast cancer,TNBC)临床病理特征的分析,探讨影响三阴性乳腺癌患者的复发、转移因素和转移淋巴结与原发灶位置之间关系。方法收集哈医大附属肿瘤医院2008年12月—2012年12月资料完整的763例三...目的通过对三阴性乳腺癌(Triple-negative breast cancer,TNBC)临床病理特征的分析,探讨影响三阴性乳腺癌患者的复发、转移因素和转移淋巴结与原发灶位置之间关系。方法收集哈医大附属肿瘤医院2008年12月—2012年12月资料完整的763例三阴性乳腺癌患者的临床资料进行回顾性分析。结果三阴性乳腺癌平均发病年龄49岁,早期患者占84.7%,淋巴结阳性患者复发、转移率均明显高于淋巴结阴性患者,并随淋巴结数目的增多而增加( P <0.001),对于淋巴结阴性患者,原发灶位于内象限时复发、转移率最高(9.8%和13.7%)( P <0.05)。单因素分析显示淋巴结状态、手术方式、放疗剂量是影响三阴性乳腺癌患者复发、转移的因素( P <0.05)。多因素分析显示临床分期、淋巴结状态是影响三阴性乳腺癌复发的独立危险因素,临床分期和和手术方式是影响三阴性乳腺癌转移的独立危险因素( P <0.05)。结论(1)三阴性乳腺癌患者早期病例所占比例高,主要病理类型为浸润性导管癌,ki67阳性表达率高;(2)淋巴结阳性患者预后与转移淋巴结数目相关,和原发灶位置无关,对于淋巴结阴性患者,原发灶位于内象限复发、转移率最高;(3)TNBC患者复发率随BMI值的增加而增加,但对于肥胖患者,复发率反而下降;(4)淋巴结状态、临床分期、手术方式、放疗剂量均影响三阴性乳腺癌患者的复发、转移;(5)临床分期、淋巴结状态是影响三阴性乳腺癌复发的独立危险因素,临床分期和和手术方式是影响三阴性乳腺癌转移的独立危险因素。展开更多
Maintaining the balance between eliciting immune responses against foreign pro-teins and tolerating self-proteins is crucial for maintenance of homeostasis.The functions of programmed death protein 1(PD-1)and its liga...Maintaining the balance between eliciting immune responses against foreign pro-teins and tolerating self-proteins is crucial for maintenance of homeostasis.The functions of programmed death protein 1(PD-1)and its ligand programmed death ligand 1(PD-L1)are to inhibit immune responses so that over-reacting immune cells does not cause any damage to its own body cells.However,cancer cells hijack this mechanism to attenuate immune cells functions and create an immunosuppressive environment that fuel their continuous growth and proliferation.Over the past few years’rapid development in cancer immunotherapy has opened a new avenue in cancer treatment.Blockade of PD-1 and PD-L1 has become a potential strategy that rescue the functions of immune cells to fight against cancer with high efficacy.Initially,immune checkpoint monotherapies were not very successful,making breast cancer less immunogenic.Although,recent reports support the presence of tumor infiltrating lympho-cytes(TILs)in breast cancer that make it favorable for PD-1/PD-L1 mediated immunotherapy,which is effective in PD-L1 positive patients.Recently,anti-PD-1(pembrolizumab)and anti-PD-L1(atezolizumab)gets FDA approval for breast cancer treatment and make PD-1/PD-L1 immunotherapy is meaningful for further research.Likewise,this article gathered understand-ing of PD-1 and PD-L1 in recent years,their signaling networks,interaction with other mole-cules,regulations of their expressions and functions in both normal and tumor tissue microenvironments are crucial to find and design therapeutic agents that block this pathway and improve the treatment efficacy.Additionally,authors collected and highlighted most of the important clinical trial reports on monotherapy and combination therapy.展开更多
文摘目的通过对三阴性乳腺癌(Triple-negative breast cancer,TNBC)临床病理特征的分析,探讨影响三阴性乳腺癌患者的复发、转移因素和转移淋巴结与原发灶位置之间关系。方法收集哈医大附属肿瘤医院2008年12月—2012年12月资料完整的763例三阴性乳腺癌患者的临床资料进行回顾性分析。结果三阴性乳腺癌平均发病年龄49岁,早期患者占84.7%,淋巴结阳性患者复发、转移率均明显高于淋巴结阴性患者,并随淋巴结数目的增多而增加( P <0.001),对于淋巴结阴性患者,原发灶位于内象限时复发、转移率最高(9.8%和13.7%)( P <0.05)。单因素分析显示淋巴结状态、手术方式、放疗剂量是影响三阴性乳腺癌患者复发、转移的因素( P <0.05)。多因素分析显示临床分期、淋巴结状态是影响三阴性乳腺癌复发的独立危险因素,临床分期和和手术方式是影响三阴性乳腺癌转移的独立危险因素( P <0.05)。结论(1)三阴性乳腺癌患者早期病例所占比例高,主要病理类型为浸润性导管癌,ki67阳性表达率高;(2)淋巴结阳性患者预后与转移淋巴结数目相关,和原发灶位置无关,对于淋巴结阴性患者,原发灶位于内象限复发、转移率最高;(3)TNBC患者复发率随BMI值的增加而增加,但对于肥胖患者,复发率反而下降;(4)淋巴结状态、临床分期、手术方式、放疗剂量均影响三阴性乳腺癌患者的复发、转移;(5)临床分期、淋巴结状态是影响三阴性乳腺癌复发的独立危险因素,临床分期和和手术方式是影响三阴性乳腺癌转移的独立危险因素。
基金supported by the Department of Science and Technology(Nano Mission:DST/NM/NT/2018/105(G),SERB:EMR/2017/000992/HS&EMR/2017/001183)Council of Scientific and Industrial Research[(FBR Project No.31-2(274)2020e21),HCP-40],Govt.of India.
文摘Maintaining the balance between eliciting immune responses against foreign pro-teins and tolerating self-proteins is crucial for maintenance of homeostasis.The functions of programmed death protein 1(PD-1)and its ligand programmed death ligand 1(PD-L1)are to inhibit immune responses so that over-reacting immune cells does not cause any damage to its own body cells.However,cancer cells hijack this mechanism to attenuate immune cells functions and create an immunosuppressive environment that fuel their continuous growth and proliferation.Over the past few years’rapid development in cancer immunotherapy has opened a new avenue in cancer treatment.Blockade of PD-1 and PD-L1 has become a potential strategy that rescue the functions of immune cells to fight against cancer with high efficacy.Initially,immune checkpoint monotherapies were not very successful,making breast cancer less immunogenic.Although,recent reports support the presence of tumor infiltrating lympho-cytes(TILs)in breast cancer that make it favorable for PD-1/PD-L1 mediated immunotherapy,which is effective in PD-L1 positive patients.Recently,anti-PD-1(pembrolizumab)and anti-PD-L1(atezolizumab)gets FDA approval for breast cancer treatment and make PD-1/PD-L1 immunotherapy is meaningful for further research.Likewise,this article gathered understand-ing of PD-1 and PD-L1 in recent years,their signaling networks,interaction with other mole-cules,regulations of their expressions and functions in both normal and tumor tissue microenvironments are crucial to find and design therapeutic agents that block this pathway and improve the treatment efficacy.Additionally,authors collected and highlighted most of the important clinical trial reports on monotherapy and combination therapy.
