中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
24期
11680-11684
,共5页
何莉%孟详喻%李凯莉%刘小平%刘尚勤%马梓
何莉%孟詳喻%李凱莉%劉小平%劉尚勤%馬梓
하리%맹상유%리개리%류소평%류상근%마재
平滑肌肉瘤%药物疗法%靶向治疗%预后
平滑肌肉瘤%藥物療法%靶嚮治療%預後
평활기육류%약물요법%파향치료%예후
Leiomyosarcoma%Drug therapy%Targeted therapy%Prognosis
平滑肌肉瘤(LMS)是起源于平滑肌细胞的间质性恶性肿瘤。发病机制仍不清楚。不同类型的LMS存在染色体核型异常。在LMS可观察到RB1和PTEN表达异常可激活细胞周期和PI3K/AKT信号通路。手术完全切除是治愈本病的惟一方法,不能手术切除的转移性LMS无法治愈。全身性化疗始终是姑息治疗。LMS对联合应用吉西他滨和多西他赛治疗敏感,目前成为本病的标准治疗方案。采用曲贝化疗对在LMS有效,可以使疾病长期稳定。帕唑帕尼是最近批准用于治疗LMS的一种口服多激酶抑制剂。对不同类型的LMS,目前迫切需要进一步了解其生物学特性、提高诊断水平及开发有效和毒性低的治疗药物。
平滑肌肉瘤(LMS)是起源于平滑肌細胞的間質性噁性腫瘤。髮病機製仍不清楚。不同類型的LMS存在染色體覈型異常。在LMS可觀察到RB1和PTEN錶達異常可激活細胞週期和PI3K/AKT信號通路。手術完全切除是治愈本病的惟一方法,不能手術切除的轉移性LMS無法治愈。全身性化療始終是姑息治療。LMS對聯閤應用吉西他濱和多西他賽治療敏感,目前成為本病的標準治療方案。採用麯貝化療對在LMS有效,可以使疾病長期穩定。帕唑帕尼是最近批準用于治療LMS的一種口服多激酶抑製劑。對不同類型的LMS,目前迫切需要進一步瞭解其生物學特性、提高診斷水平及開髮有效和毒性低的治療藥物。
평활기육류(LMS)시기원우평활기세포적간질성악성종류。발병궤제잉불청초。불동류형적LMS존재염색체핵형이상。재LMS가관찰도RB1화PTEN표체이상가격활세포주기화PI3K/AKT신호통로。수술완전절제시치유본병적유일방법,불능수술절제적전이성LMS무법치유。전신성화료시종시고식치료。LMS대연합응용길서타빈화다서타새치료민감,목전성위본병적표준치료방안。채용곡패화료대재LMS유효,가이사질병장기은정。파서파니시최근비준용우치료LMS적일충구복다격매억제제。대불동류형적LMS,목전박절수요진일보료해기생물학특성、제고진단수평급개발유효화독성저적치료약물。
Leiomyosarcoma (LMS) is a mesenchymal malignancy derived from the smooth muscle cell. The mechanisms of genesis are still unknown. The karyotypic defects are existed in the different subtypes of leiomyosarcoma. Abnormal cell cycle through RB1 and PI3K/AKT pathway activation are observed in leiomyosarcoma. Patients with unresectable metastatic leiomyosarcoma are incurable and the chemotherapy for systemic disease is always palliative. The only curative option in LMS is surgery. LMS is sensitive to the combination of gemcitabine and docetaxel regimen, which is currently considered a standard of treatment in those patients. Chemotherapy with trabectedin has shown exquisite activity in leiomyosarcoma, mainly in the form of long disease stabilization. Pazopanib is an oral multikinase inhibitor recently approved for the treatment of leiomyosarcoma. Better understanding of the underlying biology of the LMS variants, improved diagnostics and more effective, less toxic therapeutic agents are required.