Anti -cancer has a way 丨 one article takes you to understand what tumor gene testing is

【Open Language】

The incidence of malignant tumors has continued to rise, seriously threatening human health. Tumor treatment is a systematic engineering that requires scientific methods, high sense of responsibility and warm love. Professor Zhang Haibo of the Department of Oncology of Guangdong Provincial Hospital of Traditional Chinese Medicine will regularly push the latest progress in tumor prevention and control through anti -cancer column and related science popularization knowledge to preach to you. Although the road of anti -cancer is long, we are willing to walk with you! Welcome to continue to pay attention!

Speaking of genetic testing, the first thing many people think of is to detect genetic diseases or predict whether they will get tumors. The most famous representative is American movie star An Gilina Julie. Her mother and aunt suffer from breast cancer. Therefore, after doing genetic testing, she found that herself inherited the BRCA1 gene (abbreviation of Brest Cancer breast cancer). The risk of breast cancer with a population mutation of the BRCA1/2 gene will increase by 5 times. The risk of ovarian cancer will increase by 10- 30 times! So she resolutely resulted in surgical resection of the breast and ovaries to prevent possible cancer.

Of course, the ending of the story has not been known, but at least it has made many people start to understand and understand genetic testing. Let's follow the footsteps of Professor Zhang Haibo of Guangdong Provincial Hospital of Traditional Chinese Medicine to show you what genetic testing is.

First of all, genetic testing refers to the "physical examination" of genes through advanced sequencing methods, to find relevant mutation genes and mutant sites, and provide reliable basis for further treatment, drug resistance, course detection, and understanding of prognosis. Simply put, genetic testing is the gene to detect mutations.

What does the gene change?

Because in the process of life, our human body will always have cell aging and death, and new cells will be born, and DNA is usually accurately copied during the process of cell newborn division, but occasionally errors occur. It may be caused by environmental factors (smoking and other adverse factors such as smoking) during copying, but with the accumulation of mutations, these cells will no longer follow the rules "work and life", and eventually form tumor cells. After detecting these mutations genes, it is like grasping part of the "disease root" and can be used for the right medicine.

Can gene test be used as a means of cancer screening?

From the current point of view, genetic testing is not suitable as a screening. First of all, the cost is relatively high. According to the differences in the detection gene package, about thousands to tens of thousands of yuan; second, even if there is cancer genes, it does not mean that there will be cancer. Warning. For discovering related cancer genes, we can avoid daily habits and regular inspections.

In the example of Angelina Julie, surgical resection may look a bit overwhelmed. After all, surgery is also risky, but if you choose to review the breast and gynecological ultrasound regularly, you may also find problems at a very early stage and then deal with it through surgery. Healing, maybe she would not have gynecological tumors in her lifetime.

What can gene test results bring to patients?

In fact, in addition to understanding genetic risks, genetic testing is the most powerful in guiding medication. For patients who have just discovered cancer, some have undergone surgery, some have performed a puncture or endoscopic biopsy. After obtaining some tissue pathological specimens, in addition to the pathological diagnosis, tumor doctors often recommend that patients use the tissue for genetic testing. As a guidance for future medication.

For example, non-small cell lung cancer (1 type of lung cancer, accounting for about 85%) patients with about 50%of patients with EGFR gene mutations, while 3-5%of ALK mutations with "diamond mutation" The former has often been able to obtain a good curative effect from oral TKI targeted drugs, and the latter's 3 -year survival rate can even exceed 90%, which is very important and safer to these patients. Such examples also occur in KRAS/Braf/NARS, breast cancer (BRCA), gastric cancer (HER-2) and so on.

In addition, the result of gene testing is not only applicable to the choice of targeted drugs, but also can also be applied to the choice of immunotherapy. For example, PD-L1 expression, microbriets instability (MSI), and tumor mutation load (TMB) are performed before immunotherapy. ) And specific genetic mutation. Although immunotherapy brings good curative effects, some unique immune adverse reactions have caused many patients to trouble, and even lose their lives. Therefore, it is necessary to select patients with appropriate immunotherapy through genetic testing. In the future, there may be more ways to screen the advantages of a certain treatment to make the treatment more accurate!

After a genetic test, why do you do it?

Many patients may have done genetic testing at the beginning of the diagnosis, but if postoperative recurrence or disease progress occurs later, the tumor doctor may require a genetic test again. Why is this? The main reason is that the occurrence of tumors is a process of continuous dynamic changes. In the past, the results of the genetic testing could not show the current tumor state. The tumor has become more "cunning". true colors".

For example, when lung cancer is not good at controlling targeted drugs, you can re -examine the tissue for genetic testing to see if there are new mutations or T790M mutations. Applying the corresponding targeted drugs can make the disease effectively controlled again. If there is no way to obtain tumor tissue, you can also obtain similar results through liquid biopsy technology (blood drawing) gene detection. In addition to genetic testing, is there any other way?

There is also a very hot test called "Organoid", which has become a key research and development direction of the National Science and Technology "Fourteenth Five -Year Plan". The meaning of organs is actually cultivating "organs" in vitro through 3D cells. Although it is not a real organ and tissue, it has high similarity, because primitive cells come from this person.

For example, just like Sun Wukong, pulling a slightest hair from his body can change tens of millions of monkeys and monkeys. In this way, the organic technology can make the cultivated cells. Medicine, that is, medicines test. Then the results show that if a chemotherapy drug is valid on the "substitute", it can be effective for most of them. Through the continuous maturity of technology, it is believed that future organ technology can be brilliant in tumor treatment!

So if you or your friends are troubled in this aspect of genetic testing, especially after experiencing some treatment, the effect is not good after treatment, and new treatment plans are urgently needed. While the treatment plan or suggestion, you can bring you new hope!

【Medical Guidance】

Zhang Haibo, a doctor of medicine, a professor, a chief physician, a doctoral supervisor; the teacher Zhou Yanhan, Zhu Liangchun, Guo Ziguang, Li Shizhen, and the famous Chinese medicine doctor Liu Weisheng from the master of Chinese medicine.

The young and middle -aged traditional Chinese medicine medicine of the Chinese Academy of Traditional Chinese Medicine; the first outstanding young medical talents in Guangdong Province; the target of the "100" engineering talents in Guangdong Province. The Vice Chairman of the Integrated Cancer Specialty Committee and the Tumor Specialist Committee; Deputy Chairman of the Tumor Youth Specialty Committee of the Chinese Medicine Society; Chairman of the Cancer Precision and Integrated Treatment Specialist Committee of the Guangdong Provincial Society of Traditional Chinese Medicine; The Hospital Association's Tumor Molecular A targeted therapy deputy chairman; the deputy chairman of the Cancer Rehabilitation and Treatment Specialist Committee of the Guangdong Provincial Traditional Chinese Medicine Society; a member of the American Cancer Clinical Association (ASCO), and a young member of the China Cancer Clinical Association (CSCO).

【team introduction】

The research team of malignant tumor syndrome differentiation and precision therapy research team used Professor Liu Weisheng, a nationwide old Chinese medicine medicine, as an academic consultant. Professor Zhang Haibo was the academic leader. The team cooperates with the Beijing Academy of Sciences Beijing Genome Research Institute, the National Protection Science Center (Beijing), the US MD Anderson Cancer Center, UCLA University of the United States, the University of Cardiff University, and the University of Utrechi University of the Netherlands (UMCU). The research content covers the malignant tumor Traditional Chinese and Western Medicine Basic and Clinical Studies, including acupuncture to improve quality of life, standardization of syndrome differentiation of traditional Chinese medicine, molecular pathology, liquid biopsy, Chinese medicine clinical studies, traditional Chinese medicine pharmacology, genomics, metabolic groups, etc. Traditional Chinese and Western medicine combined treatment levels and promote the internationalization of Chinese medicine. He presided over 1 key research and development plan of the Ministry of Science and Technology, 4 national nature, 3 provincial and ministerial projects, and published more than 80 papers (more than 30 SCI included, the highest impact factor 22.416), and published 11 monographs (1 English monograph 1) ; I have won two national invention patents, and 2 second prizes of the Scientific and Technological Progress of Guangzhou University of Traditional Chinese Medicine.

[List of the main members of the team]

[Introduction to the author in this issue]

Chen Yadong, a master's degree in medicine, a Chinese medicine practitioner, researching intern. The Executive Director of the Integrated Tumor Committee of the World Chinese Medicine Society, youth members of the Cancer Precision and Integrated Treatment Society of the Guangdong Provincial Society of Traditional Chinese Medicine, and currently engaged in clinical research on traditional Chinese and western medicine engaged in malignant tumors such as lung cancer and gastrointestinal tract.

Supply: One (Tumor) Department of Dade Road General Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine

Executive editor: Wu Yuan Tuan

Audit school pair: Zhuang Yingge

Editor in charge: Song Liping

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