背景与目的:三阴乳腺癌(triple-negative breast cancer)指雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和HER2/neu均无表达的乳腺癌,被认为是一种独立的临床病理类型,以侵袭性强、预后较差为主要特征的乳...背景与目的:三阴乳腺癌(triple-negative breast cancer)指雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和HER2/neu均无表达的乳腺癌,被认为是一种独立的临床病理类型,以侵袭性强、预后较差为主要特征的乳腺癌。本研究目的在于分析三阴乳腺癌的临床特征和影响预后的因素。方法:收集2000年1月至2004年12月中山大学肿瘤防治中心收治的经病理组织学证实、有完整随访资料的1280例可手术乳腺癌患者的临床资料,经病理学检查证实ER、PR和HER2/neu均为阴性的三阴乳腺癌305例(23.8%)。回顾性分析三阴乳腺癌患者的临床特征、复发及生存情况。结果:本组乳腺癌患者中有23.8%(305/1280)是三阴乳腺癌,多见于年轻患者,诊断时肿块较大、局部淋巴结阳性者较多,有乳腺癌家族史的患者较多。截止至2007年6月,三阴乳腺癌组患者中位随访时间为52个月(28～89个月),有234例患者出现复发及转移,94例已死亡。三阴乳腺癌组局部复发率与非三阴乳腺癌患者相比无显著性差异;但三阴乳腺癌患者远处转移发生率显著增高,主要表现肺转移(HR=4.41,P<0.001)和肝转移(HR=2.13,P=0.006)发生率高。生存分析显示,三阴乳腺癌患者的5年无病生存率和总生存率分别为73.7%和88.5%,均显著低于非三阴乳腺癌患者(80.8%和92.8%,P=0.025,P=0.010)。多因素分析显示,肿块大小和淋巴结状况是影响三阴乳腺癌预后的两个主要因素。结论:三阴乳腺癌在乳腺癌中占有约1/4的比例。这些患者往往年轻、有乳腺癌家族史、肿块较大、淋巴结阳性多。三阴乳腺癌容易出现肺转移和肝转移,这可能是导致三阴乳腺癌预后较差的重要原因。展开更多
Within the cell, several mechanisms exist to maintain homeostasis of the endoplasmic reticulum （ER）. One of the primary mechanisms is the unfolded protein response （UPR）. In this review, we primarily focus on the ...Within the cell, several mechanisms exist to maintain homeostasis of the endoplasmic reticulum （ER）. One of the primary mechanisms is the unfolded protein response （UPR）. In this review, we primarily focus on the latest signal webs and regulation mechanisms of the UPR. The relationships among ER stress, apoptosis, and cancer are also discussed. Under the normal state, binding immunoglobulin protein （BiP） interacts with the three sensors （protein kinase RNA-like ER kinase （PERK）, activating transcription factor 6 （ATF6）, and inositol-requiring enzyme la （IREla）） Under ER stress, misfolded proteins interact with BiP, resulting in the release of BiP from the sensors. Subsequently, the three sensors dimerize and autophosphorylate to promote the signal cascades of ER stress. ER stress includes a series of positive and negative feedback signals, such as those regulating the stabilization of the sensors/BiP complex, activating and inactivating the sensors by autophosphorylation and dephosphorylation, activating specific transcription factors to enable selective transcription, and augmenting the ability to refold and export. Apart from the three basic pathways, vascular endothelial growth factor （VEGF）-VEGF receptor （VEGFR）-phospholipase C-~ （PLCy）-mammalian target of rapamycin complex 1 （mTORC1） pathway, induced only in solid tumors, can also activate ATF6 and PERK signal cascades, and IREla also can be activated by activated RAC-alpha serine/threonine-protein kinase （AKT）. A moderate UPR functions as a pro-survival signal to return the cell to its state of homeostasis. However, persistent ER stress will induce cells to undergo apoptosis in response to increasing reactive oxygen species （ROS）, Ca2＋ in the cytoplasmic matrix, and other apoptosis signal cascades, such as c-Jun N-terminal kinase （JNK）, signal transducer and activator of transcription 3 （STAT3）, and P38, when cellular damage exceeds the capacity of this adaptive response.展开更多
文摘背景与目的:三阴乳腺癌(triple-negative breast cancer)指雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和HER2/neu均无表达的乳腺癌,被认为是一种独立的临床病理类型,以侵袭性强、预后较差为主要特征的乳腺癌。本研究目的在于分析三阴乳腺癌的临床特征和影响预后的因素。方法:收集2000年1月至2004年12月中山大学肿瘤防治中心收治的经病理组织学证实、有完整随访资料的1280例可手术乳腺癌患者的临床资料,经病理学检查证实ER、PR和HER2/neu均为阴性的三阴乳腺癌305例(23.8%)。回顾性分析三阴乳腺癌患者的临床特征、复发及生存情况。结果:本组乳腺癌患者中有23.8%(305/1280)是三阴乳腺癌,多见于年轻患者,诊断时肿块较大、局部淋巴结阳性者较多,有乳腺癌家族史的患者较多。截止至2007年6月,三阴乳腺癌组患者中位随访时间为52个月(28～89个月),有234例患者出现复发及转移,94例已死亡。三阴乳腺癌组局部复发率与非三阴乳腺癌患者相比无显著性差异;但三阴乳腺癌患者远处转移发生率显著增高,主要表现肺转移(HR=4.41,P<0.001)和肝转移(HR=2.13,P=0.006)发生率高。生存分析显示,三阴乳腺癌患者的5年无病生存率和总生存率分别为73.7%和88.5%,均显著低于非三阴乳腺癌患者(80.8%和92.8%,P=0.025,P=0.010)。多因素分析显示,肿块大小和淋巴结状况是影响三阴乳腺癌预后的两个主要因素。结论:三阴乳腺癌在乳腺癌中占有约1/4的比例。这些患者往往年轻、有乳腺癌家族史、肿块较大、淋巴结阳性多。三阴乳腺癌容易出现肺转移和肝转移,这可能是导致三阴乳腺癌预后较差的重要原因。
基金Project supported by the National Basic Research Program(973)of China(No.2012CB518900)the National Natural Science Foundation of China(Nos.31160240 and 31260621)+2 种基金the National Major Scientific and Technological Special Project during the Twelfth Five-year Plan Period of China(No.2012ZX10002006)the Hangzhou Normal University Supporting Project(No.PE13002004042)the Natural Science Foundation of Jiangxi Province(No.20114BAB204016),China
文摘Within the cell, several mechanisms exist to maintain homeostasis of the endoplasmic reticulum （ER）. One of the primary mechanisms is the unfolded protein response （UPR）. In this review, we primarily focus on the latest signal webs and regulation mechanisms of the UPR. The relationships among ER stress, apoptosis, and cancer are also discussed. Under the normal state, binding immunoglobulin protein （BiP） interacts with the three sensors （protein kinase RNA-like ER kinase （PERK）, activating transcription factor 6 （ATF6）, and inositol-requiring enzyme la （IREla）） Under ER stress, misfolded proteins interact with BiP, resulting in the release of BiP from the sensors. Subsequently, the three sensors dimerize and autophosphorylate to promote the signal cascades of ER stress. ER stress includes a series of positive and negative feedback signals, such as those regulating the stabilization of the sensors/BiP complex, activating and inactivating the sensors by autophosphorylation and dephosphorylation, activating specific transcription factors to enable selective transcription, and augmenting the ability to refold and export. Apart from the three basic pathways, vascular endothelial growth factor （VEGF）-VEGF receptor （VEGFR）-phospholipase C-~ （PLCy）-mammalian target of rapamycin complex 1 （mTORC1） pathway, induced only in solid tumors, can also activate ATF6 and PERK signal cascades, and IREla also can be activated by activated RAC-alpha serine/threonine-protein kinase （AKT）. A moderate UPR functions as a pro-survival signal to return the cell to its state of homeostasis. However, persistent ER stress will induce cells to undergo apoptosis in response to increasing reactive oxygen species （ROS）, Ca2＋ in the cytoplasmic matrix, and other apoptosis signal cascades, such as c-Jun N-terminal kinase （JNK）, signal transducer and activator of transcription 3 （STAT3）, and P38, when cellular damage exceeds the capacity of this adaptive response.
