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Editorial Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 2 [ISSN 1584 – 9341] 12. Hoară P, Bîrlă R, Gîndea C, Constantin A, Panaitescu G, Iordan N, Constantinoiu S. The role of esophageal manometry in the management of the patients with gastro-esophageal reflux disease and Barrett's esophagus. Chirurgia. 2008; 103(4): 407-412. 13. Hoară P, Bîrlă R. Boala de reflux gastro- esofagian. In Bratucu E. editor. Manual de chirurgie pentru studenţi, Bucureşti, Ed Universitară „Carol Davila”, 2009; p. 355-364. 14. Klaus A, Weiss H. Is preoperative manometry in restrictive bariatric procedures necessary. Obes Surg. 2008; 18(8): 1039-1042. 15. Cruiziat C, Roman S, Robert M, Espalieu P, Laville M, Poncet G, Gouillat C, Mion F. High resolution esophageal manometry evaluation in symptomatic patients after gastric banding for morbid obesity. Dig Liver Dis. 2011; 43(2): 116-120. 141
Articole de sinteză Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 2 [ISSN 1584 – 9341] PROFILUL MOLECULAR AL CANCERULUI MAMAR: DE LA GENE LA TRĂSĂTURI MORFOLOGICE Carmen Ionescu, Cornelia Amălinei, Raluca Balan, Adriana Grigoraş, Irina-Draga Căruntu Disciplina Histologie Universitatea de Medicină şi Farmacie „Gr.T. Popa” Iaşi THE MOLECULAR PROFILE OF BREAST CANCER: FROM GENES TO HISTOLOGICAL FEATURES (Abstract): During the last decade, one of the main directions in the breast cancer research was oriented to the genetic profile, focusing on a deeper understanding of the molecular background that sustains the biological features (such as histological grade and metastasis potential) as well as on a better identification of some specific patterns, correlated with prognosis and therapeutic responses. The definition of new subtypes, in accordance with the genetic expression confirms, at the molecular level, the already existing concept of clinical and histological heterogeneity for the breast cancer. Despite a large number of papers dedicated to this subject, there are still unclear issues in the characterization of the molecular subtypes and, most probably, the number of subtypes known today is not the final one. This review, based on the information available in the publication mainstream, aims to offer a synthesis of the most recent concepts implemented in the breast carcinoma diagnosis. The text highlights the following topics: (i) the histological structure of the normal mammary gland, compulsory for the implementation of the new taxonomy and the hypothesis regarding the origin of breast cancer; (ii) the role of Stanford group in defining the genetic signature of breast cancer; (iii) the development and characteristics of the genetic tests available for breast cancer investigation; (iv) the usage of immunohistochemistry, as an alternative solution for genetic tests; (v) the molecular subtypes in correlation with immunohistochemical markers and histological features. KEY WORDS: BREAST CANCER, MOLECULAR CLASSIFICATION, GENETIC TESTS, HISTOLOGICAL CLASSIFICATION Corespondenţă: Prof. dr. Irina-Draga Căruntu, Universitatea de Medicină şi Farmacie „Gr.T. Popa” Iaşi, Disciplina Histologie, str. Universitaţii, nr.16, e-mail: irina_caruntu@yahoo.com * . Cancerul mamar (CM) este principala cauză de mortalitate la sexul feminin, fiind raportate, anual, peste 500000 de decese [1]. În ultimul deceniu, în abordarea diagnostică şi terapeutică a CM au intervenit modificări majore, ca rezultat al aprofundării mecanismului patogenic la nivel genic. Astfel, CM este considerat în prezent un ansamblu de boli heterogene, individualizate prin diferenţe la nivel molecular, histopatologic şi clinic, datorate în principal punctului iniţial de origine, reprezentat de diferite linii celulare şi/sau de celule stem existente în teritoriul glandei mamare [2]. Factorii clinici, histopatologici şi moleculari larg acceptaţi ca având valoare de factori de prognostic includ: vârsta, gradul tumoral, mărimea tumorii, statusul limfoganglionilor, prezenţa metastazelor, tipul histologic, expresia receptorilor hormonali (receptorul estrogenic (RE) şi receptorul progesteronic (RP)), expresia receptorului 2 al factorului de creştere epidermic (eng. Epidermal Growth Factor Receptor – EGFR/HER2/neu), invazia peritumorală vasculară [2]. * received date: 21.01.2011 accepted date: 24.03.2011 142
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