Diagnostic Revolution Los Ntawm Cov Ncauj Sampling Rau Molecular Subtyping

Mis biopsy koob ua lub luag haujlwm tseem ceeb hauv cov tshuaj precision rau mob qog noj ntshav mis. Cov qauv ntaub so ntswg uas lawv tau txais tsis yog tsuas yog lub hauv paus rau kev kuaj mob pathological, tab sis kuj tseem yog cov ntaub ntawv tseem ceeb rau molecular subtyping, kev xaiv kev kho mob, thiab kev soj ntsuam prognostic. Nrog rau kev nce qib sai ntawm kev kuaj mob molecular pathological, cov txheej txheem kev xav tau rau cov koob tshuaj biopsy tau hloov zuj zus los ntawm "tau txais cov ntaub so ntswg txaus" mus rau "tau txais cov qauv zoo, tsis zoo rau kev tshuaj xyuas ntau yam omics".

Technological Evolution ntawm Molecular Pathological Diagnosis

Kev kuaj mob qog noj ntshav mis ib txwm nyob ntawm kev soj ntsuam histomorphological thiab txwv cov cim immunohistochemical (xws li ER, PR, HER2). Cov kev faib tawm rau hauv Luminal A / B, HER2-enriched, thiab triple-negative subtypes tau zoo heev kev kho endocrine thiab anti-HER2 tsom rau kev kho mob, tab sis nws tsis tuaj yeem piav qhia tag nrho cov kev sib raug zoo ntawm tus neeg mob heterogeneity nyob rau hauv prognosis thiab kho cov lus teb. Tsav los ntawm kev nce qib sai hauv cov kab mob molecular, tshwj xeeb tshaj yog qhov kev siv dav dav ntawm cov kab ke txuas ntxiv tom ntej (NGS), kev kuaj mob qog noj ntshav mis tau hloov pauv los ntawm cov qauv morphological thiab IHC-raws li subtyping mus rau hauv ib lub sijhawm ntawm kev faib ua feem hauv cov genomic, transcriptomic, thiab proteomic profiling.

Genetic Testing raws li qhov yuav tsum tau ua ntawm kev kho mob

Kev hloov kho xyoo 2025 rau CSCO thiab NCCN Cov Kev Qhia Txog Kev Mob Cancer Breast ntxiv qhia txog lub luag haujlwm tseem ceeb ntawm kev ntsuam xyuas caj ces hauv kev tswj mob qog noj ntshav. Kev ntsuam xyuas noob caj noob ces tau hloov pauv los ntawm cov txheej txheem xaiv tau mus rau qhov yuav tsum tau ua, ua rau lub sijhawm tshiab ntawm kev ua kom zoo nkauj molecular subtyping. 2025 CSCO Cov Lus Qhia ntxiv cov noob PIK3CA raws li lub hom phiaj kev sim thiab nce qib kev pom zoo rau BRCA1/2 kev hloov pauv-kho cov kev kho mob. Hauv seem ntawm kev kuaj mob qog noj ntshav thiab kuaj mob, cov lus qhia tau pom zoo niaj hnub kuaj PIK3CA ua ntej kev kho thawj kab rau cov neeg mob uas muaj cov tshuaj hormone receptor-positive, HER2-negative hauv zos qib siab lossis mob qog nqaij hlav cancer mis, nrog NGS lossis PCR raws li kev pom zoo rau kev kuaj pom.

Cov Kev Xav Tau Zoo rau Cov Qauv Biopsy

Niaj hnub nimno molecular pathology imposes stricter cov qauv ntawm biopsy kuaj. Txawm hais tias nplua-needle aspiration (FNA) yog qhov me me uas cuam tshuam nrog qhov teeb meem qis dua 1%, nws muab cov khoom siv ntawm tes tsis txaus rau kev kuaj ntau lub noob. Vacuum-assisted biopsy (VAB) khaws cov ntaub so ntswg loj dua, cov ntaub so ntswg tsis zoo nrog ib qho qauv loj tshaj 20 mg thiab cov cellular degeneration tus nqi qis dua 5%, ua rau nws zoo tagnrho rau kev nthuav dav molecular profiling. Cov kev tshawb fawb qhia tias percutaneous mis biopsy ua ke nrog IHC ua tiav qhov kev kuaj pom tseeb txog li 95%, thiab cov txheej txheem thoob ntiaj teb lees paub nws yog tus qauv kub rau kev kuaj mob cancer mis.

Hloov tshiab rau Cov Kev Cai Siv Tshuaj Kho Mob

Cov Lus Qhia Txog Kev Siv Tshuaj Kho Mob rau Kev Ntsuas Molecular Pathological ntawm Kev Mob Cancer Breast (2025 Edition) pom zoo kom kuaj PD-L1 rau cov neeg mob uas muaj mob qog noj ntshav triple-negative los qhia kev xaiv kev kho mob. Rau cov neeg mob qog noj ntshav siab siab uas muaj cov cim tsis zoo ntawm cov cim molecular thiab cov kab mob loj zuj zus txawm hais tias kev kho tus qauv, pan-solid-tumor molecular profiling yog pom zoo qhov uas muaj peev xwm txheeb xyuas cov peev txheej kev kho mob, suav nrog NTRK / RET fusions, MSI-H / dMMR, thiab TMB-H. Cov vaj huam sib luag loj NGS raug pom zoo rau kev tshawb nrhiav ib txhij los txhim kho kev sim ua haujlwm.

Technology Platform Xaiv thiab Kev Ua Kom Zoo Tshaj Plaws

Cov lus qhia tseem ceeb tshaj plaws rau NGS rau kev mob qog noj ntshav ntawm lub mis, vim nws ua rau muaj kev tshuaj ntsuam ntau hom noob ib txhij, ua kom haum rau ntau hom qauv xws li cov ntaub so ntswg thiab cov kua dej biopsies, thiab txo cov nqaij mos noj. Txawm li cas los xij, NGS muaj cov kev txwv hauv kev tshawb nrhiav cov noob fusions; FISH lossis RT-PCR tej zaum yuav xav tau rau kev kuaj pom tseeb. Qhov no tsim cov kev xav tau tshiab ntawm cov koob tshuaj biopsy: lawv yuav tsum tau txais cov ntaub so ntswg zoo txaus thaum txo qis kev raug mob thiab cov cellular degeneration kom lav qhov kev kuaj xyuas qhov tseeb.

Cov Lus Qhia Txog Kev Txhim Kho Yav Tom Ntej

Nrog rau kev nce qib hauv cov kua dej biopsy, circulating qog DNA (ctDNA) tau tshwm sim los ua ib qho kev hloov tshiab rau kev soj ntsuam mob qog noj ntshav. Txawm li cas los xij, cov ntaub so ntswg biopsy tseem yog tus qauv ntsuas kub, tshwj xeeb tshaj yog rau kev ntsuam xyuas cov lus teb neoadjuvant thiab tshawb xyuas cov txheej txheem tiv thaiv. Cov koob txhaj tshuaj biopsy yav tom ntej yuav dhau los ua neeg txawj ntse, sib koom ua ke ntawm lub sijhawm tiag tiag ntawm kev tshuaj ntsuam xyuas molecular kom xa cov ntaub ntawv ua ntej ntawm qhov chaw molecular thiab txhawb kev txiav txim siab tam sim ntawd. Lub caij no, kev sib koom ua ke ntawm qhov kev kuaj mob me me nrog cov duab taw qhia thiab kev txawj ntse txawj ntse yuav ntxiv dag zog rau cov txheej txheem precision thiab kev nyab xeeb, txhawb kev kho mob qog noj ntshav mis mus rau tus kheej ntau dua thiab raug.