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肿瘤风险提前预防 西南首个肿瘤遗传咨询门诊在渝成立

2017-08-31 14:11:05   央广网

央广网重庆8月31日消息(记者陈鹏)记者从重庆市肿瘤医院获悉,西南地区首个“肿瘤遗传咨询门诊”目前已经在该院正式成立。该门诊由由妇瘤科、乳腺科、胃肠外科、消化内科、病理科、肿瘤学实验室等多科室专家联合组成,旨在为咨询者分析评估肿瘤遗传风险,普及肿瘤遗传相关知识,提供肿瘤预防、筛查方案及遗传学检测等服务。

重庆市肿瘤防治办公室主任、遗传咨询师周琦介绍,从遗传学角度来说,可将肿瘤划分为遗传性肿瘤和有遗传倾向的肿瘤(肿瘤遗传易感性)。对遗传性肿瘤而言,遗传因素在肿瘤的发生发展中扮演重要作用。而有遗传倾向的肿瘤(肿瘤遗传易感性)则是指某个家族家系有多重肿瘤发生的情况,但不是遗传基因的携带和遗传,或是目前我们还没有认识到的大片段基因缺失或遗传。

为何要进行肿瘤遗传咨询?周琦说,肿瘤遗传易感的人群,在同一环境条件下,对于外界刺激更敏感,更容易发生肿瘤。这些人群当机体免疫功能低下时,不能及时监视、阻止细胞多步骤癌变的肿瘤易感基因,以及可以直接造成细胞增殖分化紊乱的癌基因、抑癌基因,把突变的细胞消灭,导致肿瘤发生。

此外,每种遗传性肿瘤的发生都与其特异性基因突变相关,而出现基因突变的人群在一生中罹患肿瘤的风险远远高于普通人群。目前,比较肯定的遗传性肿瘤有遗传性乳腺癌/卵巢癌、遗传性结直肠癌、遗传性子宫内膜癌等。

“科学研究证据表明,5%-10%的癌症是基因的种系突变导致的,通常具有家族聚集性。也就是一个家族中有多个成员患有同一种肿瘤或几种肿瘤,这种现象称为遗传性癌症综合征,具有发病早,恶性程度高和多发性等特点。”重庆市肿瘤医院遗传咨询师易琳说。

“不过,目前已有诸多遗传学病因是可识别可干预的。”重庆市肿瘤医院肿瘤实验室主任、遗传咨询师辇伟奇说,以乳腺癌为例,乳腺癌与BRCA1/2基因密切相关。对于BRCA1/2基因突变的女性,其一生中罹患乳腺癌的风险为70%以上。如果做了预防性乳腺切除,可以使乳腺癌发生率下降93%。“就像安吉丽娜·茱莉这样,手术后患乳腺癌的风险从87%降到了5%。”

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