肿瘤异质性-精准临床诊治的挑战

白日兰; 崔久嵬

doi:10.3969/j.issn.1000-8179.2020.21.341

肿瘤异质性-精准临床诊治的挑战

doi: 10.3969/j.issn.1000-8179.2020.21.341

白日兰,
崔久嵬^,

吉林大学第一医院肿瘤中心(长春市 130021)

基金项目:

本文课题受国家重点研发项目 2016YFC1303804

吉林省科技厅科技发展计划项目 20190303146SF

详细信息

作者简介:
白日兰, 专业方向为肿瘤综合诊治及基础研究。E-mail:bairilan@foxmail.com

崔久嵬教授，博士生导师,现任吉林大学第一医院肿瘤中心副主任，肿瘤科主任，吉林省生物治疗重点实验室负责人。兼任中国抗癌协会青年理事会副理事长、中国研究型医院生物治疗委员会副主任委员、中国研究型医院分子诊断委员会副主任委员、中国医药质量管理协会细胞治疗质量控制与研究专业委员会常委、中华医学生物免疫学会常务委员、中国抗癌协会营养与支持委员会肿瘤免疫营养学组组长、中国抗癌协会肿瘤营养专业委员会常委、中国抗癌协会肿瘤科普防治专业委员会常委、中国临床肿瘤学会理事、国家抗肿瘤药物临床应用监测专家委员会委员、中华医学会肿瘤学分会第十一届肺癌专家委员会委员等。主要研究方向为肿瘤发病机制及免疫治疗研究。负责及参与32项国家、省部级课题。曾获2020年吉林省自然科学奖一等奖，2018年吉林省青年科技奖特别奖 1项，中国分析测试协会科学技术奖二等奖 1项，吉林省科学技术成果一等奖1项，二等奖3项；获吉林省突出贡献中青年专业技术人才、吉林省卫生系统第二次拔尖创新人才、白求恩名师、吉林省高校双百人才和长春市百名优秀科技工作者称号

通讯作者:
崔久嵬, E-mail:cuijw@jlu.edu.cn

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出版历程
- 收稿日期: 2020-04-03
- 刊出日期: 2020-12-26

Tumor heterogeneity: the great challenge in precision clinical diagnosis and treatment

BAI Rilan,
Cui Jiuwei^,

Cancer Center, the First Hospital of Jilin University, Changchun 130021, China

Funds:

the National Key Research and Development Program of China 2016YFC1303804

the Science and Technology Development Project of Science and Technology of Jilin Province 20190303146SF

More Information

Corresponding author: CUI Jiuwei,E-mail:cuijw@jlu.edu.cn

摘要

摘要: 肿瘤异质性是肿瘤演化过程中出现的一个普遍而又至关重要的表现特征，是肿瘤形成及进一步演进的重要支撑点。尽管近几年，肿瘤异质性内在规律和形成机制等方面的研究有诸多新进展，但肿瘤异质性仍是实现临床精准诊治、克服耐药问题的重大挑战。近几年，随着高通量测序和单细胞测序技术的发展和不断完善，对肿瘤单个细胞或全基因组测序已逐步揭示肿瘤异质性的时空变异和分子机制。本篇文章对肿瘤异质性的复杂性、形成机制和对肿瘤演进的影响以及对临床诊治带来的挑战的最新研究进展进行综述。
- 肿瘤异质性 /
- 基因组不稳定性 /
- 肿瘤干细胞 /
- 表观遗传 /
- 药物耐受
Abstract: Tumor heterogeneity is a common and important feature in the process of tumor evolution, supporting both tumor formation and further evolution. Although advances have been made in understanding the internal laws and formation mechanisms of tumor heterogeneity, tumor heterogeneity remains a major challenge to achieving an accurate clinical diagnosis, treatment plan, and overcoming drug resistance. With the development and continuous improvement of high-throughput sequencing and single-cell sequencing technology, the spatiotemporal variation and molecular mechanisms of tumor heterogeneity have been increasingly elucidated. Here, we systematically review the latest research progress in the complexity and formation mechanism of tumor heterogeneity, the effect that tumor heterogeneity has on tumor evolution, and its challenges in relation to clinical diagnosis and treatment.
- tumor heterogeneity /
- genomic instability /
- cancer stem cell /
- epigenetics /
- drug resistance
注释:
专栏寄语:
1) 近几年，随着肿瘤细胞生物学和分子生物学研究的不断发展，研究者们深入揭示肿瘤发生发展的内在规律和分子机制，并将关键理论和认识逐步应用于肿瘤临床实践。从基础研究、转化研究再到临床研究，从外科局部治疗到内科综合管理，肿瘤研究-诊疗-管理体系日益完善，并且随着新型技术的发展，肿瘤个体化、精准化诊治理念深入人心，成为医学领域关注的热点。聚焦肿瘤基础研究和转化研究的最新进展，、深入探讨肿瘤科研和技术的发展前沿是推动肿瘤诊治水平提升的基础。由此，受《中国肿瘤临床》编辑部邀请，特开辟“中国肿瘤青年科学家奖专栏”，邀请荣获中国抗癌协会“中国肿瘤青年科学家奖”的青年学者对各自研究领域的前沿知识和研究方向进行论述，并介绍相应研究成果，以激发探索肿瘤诊治新方法的灵感和思路。

1) 吉林大学第一医院崔久嵬教授就肿瘤异质性—精准临床诊治的挑战作详细介绍；浙江大学医学院附属第一医院白雪莉教授分享了胆囊癌系统性治疗的研究进展；浙江大学医学院附属邵逸夫医院金洪传教授就 Caveolin1 在乳腺癌发生发展中的作用及其表观遗传调控机制进行了深入探究；四川大学华西第二医院周圣涛教授梳理了宫颈癌靶向治疗及免疫治疗的最新研究进展；南京医科大学公共卫生学院靳光付教授团队深入探索了染色体 1q22区域遗传变异影响胃癌易感性的生物学机制。

1) 我国肿瘤发病率高，给社会经济带来沉重负担，提高肿瘤综合治疗水平任重道远。希望以本专栏的刊出为契机，与广大同道共勉，积极开展多中心随机临床研究，获得更多中国特色的高级别循证医学证据以充实我国的指南，以指导临床实践、提高肿瘤诊治水平，实现患者高质量长期生存目标。

1) ———崔久嵬教授中国抗癌协会青年理事会副理事长

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图 1 肿瘤异质性的组成及影响

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