腫瘤基因組和基因芯(已修改)
2025-05-12 07:24 本頁面
【正文】 腫瘤基因組學(xué)與基因芯片 第十講 腫瘤的研究 ? 美國 1971年頒布國家癌癥條例開始抗癌大戰(zhàn) ? 使癌癥成為“慢性病” Concept of Neoplasm（瘤） “? is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of the stimuli which evoked the change” Willis, 1952 Basic Biologic Features of Neoplasms Oncogenic Lesion (. RAS, MYC, E2F Activation) Differentiation Abnormal Proliferation Angiogenesis Invasion Senescence Apoptosis Neoplasms Evolve in Multiple Steps ? Initiation: presumably occurs through irreversible or stable damage to DNA ? Promotion: an process bringing about a clonal expansion of initiated cells ? Progression: results when geic instability leads to further mutagenic and epigeic changes 腫瘤的發(fā)生（ Initiation） ? Tumor initiation： Cooperative DNA lesions as mon final pathway ? Precancerous and incipient（初始 的） lesions ? Molecular targets： Oncogenes, tumor suppressor genes amp。 DNA repair genes 腫瘤的促進（ promotion） ? Expansion of initiated cells ? Repetitive process Initiation amp。 Promotion ? 致癌劑 ? 腫瘤促進劑 ? 低黃曲霉素 B1Aflaloxin B1，高殺草強Amitrole，砷和其化合物 Arsenic amp。 pounds，高三氧化二砷 Arsenic trioxide，高三硫化砷 Arsenic trisulfide，高石棉 Asbestos ? 癌基因（如 myc 、 ras） ? 需要反復(fù)刺激 Initiation amp。 Promotion Time No tumor No tumor No tumor No tumor Tumor Tumor = Promoter = Initiator Gr. 1 Gr. 2 Gr. 3 Gr. 4 Gr. 5 Gr. 6 Initiation amp。 Promotion Target Genes 腫瘤的發(fā)展（ progression） ? 腫瘤組織 浸潤 相鄰組織 ? 淋巴結(jié)轉(zhuǎn)移和血道 轉(zhuǎn)移 ? 遠端轉(zhuǎn)移 Apoptosis and Tumorigenesis 小 結(jié) ? 腫瘤發(fā)生發(fā)展的三個階段 基于基因表達譜的分子分型 ? 為什么提倡利用分子水平進行腫瘤的分型？ 腫瘤的一般臨床學(xué)知識 ? 腫瘤的診斷 腫瘤的臨床分期（ stage） 腫瘤的臨床分級（ grade） ? 腫瘤的治療 放療 化療 輔助治療 靶點治療 腫瘤的臨床分期 (stage) ? TNM分期 腫瘤的大小 (T, tumor size) 腫瘤是否發(fā)生臨近的淋巴結(jié)轉(zhuǎn)移 (N, node) 腫瘤是否有遠處轉(zhuǎn)移 (M, metastasis) 乳腺癌 分 期 ? Tis Carcinoma in site ? T1 Tumor ≤ cm in greatest dimension ? T2 Tumor cm – cm in greatest dimension ? T3 Tumor cm in greatest dimension ? T4 Tumor of any size with direct extension to chest wall or skin ? N0 No regional lymph nodes metastasis ? N1 Metastasis to moveable ipsilateral axillary node(s)(同側(cè)腋下淋巴結(jié) ) ? N2 Metastasis to ipsilateral axillary node(s) fixed to one another or other structures ? N3 Metastasis to ipsilateral internal mammary node(s) ? M0 No distant metastasis ? M1 Distant metastasis (includes metastasis to ipsilateral supraclavicular（鎖骨） lymph node(s) Stage 0 Tis N0
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