青海大学附属医院结直肠癌.pptxVIP

基因检测在结直肠癌治疗中的意义青海大学附属医院胃肠外科

恶性肿瘤发病率与死亡率呈上升趋势前十位恶性肿瘤死亡率(合计)顺位200419921973-1975疾病名称死亡率(1/10万)疾病名称死亡率(1/10万)疾病名称死亡率(1/10万)1肺癌30.83胃癌25.16胃癌19.542肝癌26.26肝癌20.37食管癌18.833胃癌24.71肺癌17.54肝癌12.544食管癌15.21食管癌17.38肺癌7.095结直肠癌7.25结直肠癌5.30子宫颈癌5.236白血病3.84白血病3.64结直肠癌4.607脑瘤3.13子宫颈癌1.89白血病2.728女性乳腺癌2.90鼻咽癌1.74鼻咽癌2.329胰腺癌2.62女性乳腺癌1.72女性乳腺癌1.6510骨癌1.70恶性肿瘤总计134.80恶性肿瘤总计108.26恶性肿瘤总计83.65摘自：卫生部网站

结直肠癌病理分型

结直肠癌发生发展遗传模型

结直肠癌不同阶段生存期

EGFR分子信号通路对肿瘤细胞影响

EGFR信号通路与EGFR靶向治疗

EGFR信号通路与相关靶向药物

KRAS突变与爱必妥总生存率metastaticcolorectalcancerMichelDucreux,etal.CancerRes,2006E.VanCutsem,etal.ECCO15-ESMO34,2009

KRAS突变与爱必妥无病情发展生存率和总生存率Progression-freesurvivalOverallsurvivalofthe113pooledpatientsaccordingtothepresenceorabsenceofKRASmutation(P=1.4*10-7andP=0.0017,respectively).colorectalcancerAstridLievre,etal.JOURNALOFCLINICALONCOLOGY.2008(26),374

KRAS突变与爱必妥药效V.Heinemannetal.CancerTreatmentReviews,2009colorectalcancer

KRASBRAF突变与爱必妥响应率metastaticcolorectalcancerFLoupakis,etal.BritishJournalofCancer,2009

BRAF突变与爱必妥无病情发展生存率和总生存率Fig1.(A)Progression-freesurvivaland(B)overallsurvivalinwild-typeKRASpatientsaccordingtoBRAFstatus.M,mutated;NM,nonmutated.PierreLaurent-Puig,etal.JClinOncol,2009

PIK3CA突变与EGFR单抗疗效panitumumab/cetuximabmetastaticcolorectalcancerAndreaSartore-Bianchi,etal.CancerRes,2009

PIK3CA突变与结肠癌手术患者预后关系resectablecoloncancer(stageItoIII)Ogino,etal.JClinOncol,2009

PTEN表达与EGFR单抗疗效panitumumab/cetuximabmetastaticcolorectalcancerAndreaSartore-Bianchi,etal.CancerRes,2009

PIK3CA突变、PTEN表达与EGFR单抗疗效panitumumab/cetuximabmetastaticcolorectalcancerAndreaSartore-Bianchi,etal.CancerRes,2009

EGFR扩增，KRAS、BRAF突变，PTEN表达与爱必妥疗效PierreLaurent-Puig,etal.JClinOncol,2009

小结：相关标记物与爱必妥疗效Russoetal;Oncology2009Russoetal;Oncology2009

血管生成是恶性肿瘤快速增长所必须的StagesatwhichangiogenesisplaysaroleintumorprogressionPremalignantstageMalignanttumorTumor

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