肿瘤防治的新挑战-肿瘤异质性, 分子分型 及个体化冶疗.pptVIP

肿瘤防治的新挑战(肿瘤异质性, 分子分型, 及个体化冶疗)  中国医学科学院 北京协和医学院 肿瘤研究所 肿瘤医院 程书钧 肿瘤防治模式 高危个体 癌前病变 占位病变 预防 予警、发现 手术、放疗、化疗 生物，初级阶段 Wood,LD,et.al(Science,2007,Nov.16,Vol.318:1108) isolated DNA from 11 breast and 11 colorectal tumors and determined the sequences based on exons representing 20,857 transcript from 18,191gene. Any gene that was mutated in the tumor but not in normal tissue from the same patients was analyzed in 24 additional tumors. Pathway rather than individual genes appear to govern the course of tumorigenesis. Disruption of a pathway by mutation in any one of its genetic components would presumably lead to similar changes in growth. The 15 driver mutation in an individual tumor likely reflect alterations in a similar number of pathways. A few gene ‘mountains’ are mutated in a large proportion of tumors; most genes are mutated in 5% of tumors represented as ‘hills’两个肿瘤突变基因重复的很少， (Science 2007,318: 1108) Greenman,C et al(Nature, 2007,446:153-)reported 1,000 somatic mutations found in the coding exons of 518 protein kinase genes in 210 diverse human cancers. There was substantial variation in the number and pattern of mutations in individual cancer. Most somatic mutations are likely to be ‘passengers’ that do not contribute to oncogenesis. However, there was evidence for ‘driver’ mutation contributing to the development of the cancer studied in approximately 120 genes. Thomas,RK et al.(Nature genetics,2007,39:347-)determined 238 known oncogen mutation across 1,000 human tumor samples of 17 cancer types. Of 17 oncogens analyzed, they found 14 to be mutated at least once, and 298(30%) samples carried at least one mutation 1). Wood,LD,et.al determined the 乳腺癌和结直肠癌 DNA sequences based on exons of 20,857 transcript from 18,191gene. (Science,2007,Nov.16