乳腺癌组织学分级系统的研究进展和发展方向

摘要

组织学分级系统（ Histological classification system ，HCS）是判断和预测乳腺癌生物学行为的重要分级系统之一，本文结合国际相关文献，综述该系统的研究进展和发展方向。文献检索回顾HCS的起源及发展历程，详述Nottingham分级系统内容，分析该系统的不足，介绍新型分级系统。乳腺癌HCS发展已有百年历史，当前应用最广的Nottingham分级系统，是以癌细胞形态学为基础的系统，其存在纳入指标单一、评估变异大和评估效率低等缺点。国际上最新开发了“核＋增殖”分级系统、计算机辅助分级系统和综合预测模型等多种分级系统。乳腺癌HCS的未来发展方向将是运用高通量分析方法，在癌细胞和肿瘤微环境基础上，分析与预后密切相关的分子信息，预测患者预后和指导个体化治疗。%Histological classification system ( HCS) is an important system in judging and predicting ma-lignant behaviors of breast cancer .This study is aimed to analyze research progress and development direction of HCS by perusing literatures ,including the origin and development progress of HCS ,contents and deficiencies of Nottingham classification system(NCS),and introduction of novel classification system .HCS of breast cancer has a history of more than one hundred years ,among which NCS is the most widely used ,based on morphological fea-tures of cancer cells .However,there are still some shortcomings about NCS ,such as few indexes incorporation , great evaluation variation and low evaluation efficiency .Recently ,many newly evaluation systems have been devel-oped,including“nucleus+proliferation”classification system ,computer assisted classification system and compre-hensive prognostic classification model .Therefore,the future development directions of HCS on breast cancer is to use high throughput analysis technology to extract and analyze the hidden molecular information in cancer cells and the surrounding tumor microenvironment ,so as to better guide personalized therapy and predict clinical prog-nosis.