【佳学基因检测】免疫、增殖和分子亚型在乳腺癌预后中的相互作用

基因检测有必要做吗—解答

研讨基因检测人员学科学习手册《肿瘤靶向药物的敏感性及有效性》《Genome Biol》在. 2013 Apr 29;14(4):R34.发表了一篇题目为《免疫、增殖和分子亚型在乳腺癌预后中的相互作用》肿瘤靶向药物治疗基因检测临床研究文章。该研究由Srikanth Nagalla, Jeff W Chou, Mark C Willingham, Jimmy Ruiz, James P Vaughn, Purnima Dubey, Timothy L Lash, Stephen J Hamilton-Dutoit, Jonas Bergh, Christos Sotiriou, Michael A Black, Lance D Miller等完成。促进了肿瘤的精准治疗与个性化用药的发展，进一步强调了基因信息检测与分析的重要性。

肿瘤靶向药物及精准治疗临床研究内容关键词：

失巢凋亡,胶质母细胞瘤,免疫疗法,泛癌分析,干性指数,肿瘤微环境

肿瘤靶向治疗基因检测临床应用结果

基因解码基因检测的研究介绍：指示肿瘤增殖能力和肿瘤免疫细胞相互作用的基因表达特征已成为乳腺癌基因解码基因检测的研究结果的主要生物学驱动预测因子。这些特征如何在生物学和预后基因解码基因检测的研究介绍下相互关联仍有待澄清。基因解码基因检测的研究结果：为了研究增殖和免疫基因特征之间的关系，基因解码基因检测分析了一个综合数据集，该数据集包含 1,954 个临床注释的乳腺肿瘤表达谱，随机分为训练和测试集允许基因生存关联的双向发现和验证。分层聚类揭示了一大群具有已知免疫功能的无远处转移存活相关基因，这些基因进一步分为三个不同的免疫元基因，可能反映 B 细胞和/或浆细胞； T细胞和自然杀伤细胞；和单核细胞和/或树突状细胞。增殖元基因允许将病例分层为增殖三分位数。这些宏基因的预后强度主要局限于最高增殖三分位数内的肿瘤，尽管在中等和低增殖三分位数中观察到内在的亚型特异性差异。在高度增殖的肿瘤中，高三分位免疫宏基因表达等同于显着降低转移风险，而三分位免疫宏基因中任何一种低三分位表达的肿瘤尽管其他两种宏基因的表达较高，但与预后不良相关。基因解码基因检测的研究结论：这些发现表明肿瘤部位多种免疫细胞类型之间的有效相互作用以增殖依赖性方式促进长期抗转移免疫。在高度增殖的肿瘤中出现了一部分有效的免疫应答者，具有新的预后影响。

肿瘤发生与复发转移国际数据库描述：

Background: Gene expression signatures indicative of tumor proliferative capacity and tumor-immune cell interactions have emerged as principal biology-driven predictors of breast cancer outcomes. How these signatures relate to one another in biological and prognostic contexts remains to be clarified.Results: To investigate the relationship between proliferation and immune gene signatures, we analyzed an integrated dataset of 1,954 clinically annotated breast tumor expression profiles randomized into training and test sets to allow two-way discovery and validation of gene-survival associations. Hierarchical clustering revealed a large cluster of distant metastasis-free survival-associated genes with known immunological functions that further partitioned into three distinct immune metagenes likely reflecting B cells and/or plasma cells; T cells and natural killer cells; and monocytes and/or dendritic cells. A proliferation metagene allowed stratification of cases into proliferation tertiles. The prognostic strength of these metagenes was largely restricted to tumors within the highest proliferation tertile, though intrinsic subtype-specific differences were observed in the intermediate and low proliferation tertiles. In highly proliferative tumors, high tertile immune metagene expression equated with markedly reduced risk of metastasis whereas tumors with low tertile expression of any one of the three immune metagenes were associated with poor outcome despite higher expression of the other two metagenes.Conclusions: These findings suggest that a productive interplay among multiple immune cell types at the tumor site promotes long-term anti-metastatic immunity in a proliferation-dependent manner. The emergence of a subset of effective immune responders among highly proliferative tumors has novel prognostic ramifications.