主管单位:中华人民共和国
国家卫生健康委员会
总编辑:杨秋
编辑部主任:吴翔宇
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英文作者:Li Xiaoyan1 Yang Xu12 Wang Yuting2
单位:1川北医学院临床医学院,南充637000;2四川省成都市第五人民医院妇产科,成都611130
英文单位:1College of Clinical Medicine North Sichuan Medical College Nanchong 637000 China; 2Department of Obstetrics and Gynecology Chengdu Fifth People′s Hospital Sichuan Province Chengdu 611130 China
关键词:卵巢癌;化疗;耐药;机制
英文关键词:Ovariancancer;Chemotherapy;Drugresistance;Mechanism
虽然当前卵巢癌治疗方案在不断优化,但手术结合化疗仍是上皮性卵巢癌的主要治疗手段。以R0为目标的卵巢癌肿瘤细胞减灭术结合个体化的化疗方案的应用,使得部分患者5年生存率有了很大的提升,但晚期患者的5年生存率仍然不足30%。化疗耐药是造成卵巢癌患者死亡率居高不下的主要原因,逆转卵巢癌的耐药性是当前临床及科研工作者急需解决的难题。卵巢癌耐药机制错综复杂,主要包括药物转运、药物代谢、细胞凋亡、DNA损伤修复、表观遗传学改变等,此外多药耐药、自噬、肿瘤代谢重组、免疫、肿瘤干细胞等在卵巢癌耐药方面也发挥着重要作用。基于对各种耐药机制的深刻理解,联合用药在提高化疗敏感性、改善患者预后中具有广泛应用前景。本文就当前铂耐药卵巢癌的发病机制及治疗策略的研究进展进行综述。
Although the treatment of ovarian cancer is constantly being optimized, surgery combined with chemotherapy is still the main treatment for epithelial ovarian cancer. The application of R0 cytoreductive surgery combined with individualized chemotherapy has greatly improved the 5-year survival rate of some patients, but the 5-year survival rate of patients with advanced ovarian cancer is still lower than 30%. Resistance to chemotherapy is the main reason for the high mortality of ovarian cancer patients. Reversing the resistance of ovarian cancer is an urgent problem for clinical and scientific researchers. The mechanisms of drug resistance in ovarian cancer are complex, including drug transport, drug metabolism, apoptosis, DNA damage repair, epigenetic changes, etc. In addition, multidrug resistance, autophagy, tumor metabolic reorganization, immunity, and cancer stem cells also play an important role in ovarian cancer drug resistance. Based on the deep understanding of various drug resistance mechanisms, combination therapy has a wide application prospect in improving chemotherapy sensitivity and prognosis of patients. This article reviews the current research progress on the pathogenesis and treatment strategies of platinum-resistant ovarian cancer.
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