(tumor suppressor genes )

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??????? ?????? ?????? ?????? ??????? ??? ????

• ????? ?? ??????????????
• ??????????? ?? ???? ????? ????
• (tumor suppressor genes ) ?????? p53
• ??????????? ?? ???? ??????? ???????

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?????? ??????? ????

• ?????? ?????? ???? ??? ???? ????? ?????? ????
  ???? ?????, ?? ??? ????? ?? ???? ???
• ?????? ?????? ???? ?????? ??????? ???????
  ??????????
• ??????? ?????? ?????? ??????? ?? ??????
• ???????? ????????

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????? ????????? ?????, ???? ?????? ?????? ????????
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????? ???????????????? ?- HER2/ NEU
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?????? ????? FISH ?????? ???? ?????? ?? HER2/NEU
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?????HER2/NEU ?????

• ????? ????? ?? ???? ???? ??? ?? ??????? ?-
  HER2/NEU ?????
• ????? ???? ?????? ????? ???? ???
• ???? ??????? ?? ???? ??? ??? ??????? ??????? ????
  ????? ?????? ?????
• ???? ?????? ????? ?? ?????? ????????

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??????? - ????? ?????? ????? ?????? ?? ????
????? ??? ?? ?????? (20-30)
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Application of microarray technology in
determining breast cancer prognosis and
therapeutic response
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????? MICROARRAYS????? ???

• ???? ???? ?????? ???? ?? ?????? ?????? ?? ??
  ????? ????? ?? ???
• ???? ???? ????????? ???? ????
• ????? ??????? ????? ????????
• ???? ?????? ?????? ????
• ?????? ??????? ??? ????? ?????? ???????????

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????? ????? ?????? ?????? ???? ???

• OncotypeDX developed by Genomic Health is a
  diagnostic assay that quantifies the likelihood
  of breast cancer recurrence in women with newly
  diagnosed type I or II breast cancer that is
  node-negative and estrogen-receptor-positive who
  will be treated with Tamoxifen.
• This assay - performed using formalin-fixed,
  paraffin-embedded tissue - analyzes the
  expression of a panel of 21 genes. It was
  developed by extensive laboratory testing and
  through multiple independent clinical studies.

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????? ????? ???? ????? ?- microarray

• ????? ????? ?????? ?? ?????? ????? ?? ??????
• ??? ????? ??? ????? RNA (???? ???? ??????? ????
  ???? ???)
• ????? cDNA ??- RNA????? ???????
• ????? ?- c-DNA ?? ??? ?????? ????? ??????
  ??????????? ?????
• ????? ????? ????? ????? ?????? DNA ?? ???? ??????
  ????? ??????

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????? ????? ???? ????? ?- microarray

• ??????????? ?? ????? ?? ?-cDNA , ????? ????????.
• ????? ??????? ????? ??????, ???? ?? ?????? ?????
  ?????? ?????? ????????? ?? ?? ?????.
• ????? ???? ????? ?? ??????????????.
• ???? ?????? ?- RNA ???? ???? ???.
• ?? ???? ?????????? ???? ???? ???????? ?? ????????
  ??????.

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?????? ?????? ??????? ??? EGFR

• ?????? ????? ?? ???? ???? ????? ??? ?? EGFR,
• ???? ????? ???? ???
• ?????? ????? ????? ??????? ???????? ??????
  ?-EGFR, ??? ????? ??????
• ?? ???? ?????? ??? ????? ?????? ????? ???????
  ????
• ?????
• ??? ?? ?? ??? ??????? ??????? ??????? ??? ???
  ??????
• ??????? ????. ?????? ???? ?-EGFR ?????
  ??????????

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ERBITUX-Anti EGFR Monoclonal Antibody
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IRESSA ????? ?-EGFR
?????? ????? ????? ?????? ?? ?????? ???????
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?????? ?????? ?????? ???? ??????? ??? ?- EGFR
??? ??????? (gefitinib) Iressa ?- erlotinib)
Tarceva (????? ??????? ?????? ?????? ??????
??????? ?? ???? ?????, ??? ??????? ???? ?? ???
???? ????? ???????? ?????, ?? ????? ??????.
?????? ??????? ???? ???? ?????? ?? ?- 10 ???????
?????? ???, ?????? ????? ????? ??????. ???????
????? ???? ????? ????? ???????, ????? ??????
????? ?? ????? ????? ?? ???????? ?????? ??????,
??? ?????? ??????? ??? ???? ????? EGFR. ?????
???? ?? ??? ????? ????? ?? ??????? ??? ??????
???? ??????? ??????. ???? ??????? ????, ???? ??
????? ????? ???????? ???? ???? ????? ????? ?????
?????.
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????? ??? ?? ??????? ???? ?????? ??????? ?????
GLEEVEC ???? ?????? ?- GIST
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????? ?? ?????? CD20 ???? B ??????????
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MABTHERA
????? ??????? ?? ??? B ??????? - ???? ?- 20CD
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??? ????? ?-MABTHERA

• ???????? ???? ?????? ?????? ?????????
• ????? ?????? ??? ???? ?? ??????? ?????? ?? ???
  ??? ????? ??????
• ????? ?????? ??? ????? ?? ??????? ??????????

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???????? ???????? ?- CML
?????????? ?? ???????? 22 ????????? 9
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???????? BCR-ABL
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???????? ??? ??????
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GLEEVEC - ????? ?????? ???? ??????? ????? ??????
??????
?????? ?-CML
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AVASTIN ????? ???? ?????????
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BRCA -1 ?- BRCA-2

• ??? ?? ???? ??? ?????? ??????? ???? ???
• ?????? ???? ???? ??????? ?? ???????? ??????? ?-
  10 ?????? ?? ??? ??? 40
• ?????????? ???????, ??? ???? ????????
• ????? ??????? ???????

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BRCA-1 BRCA-2

• ?????? ????????BRCA1 1152BRCA2
  1832????????? ??????? ???????
  ??????BRCA1185delAG 5382insC
  BRCA26174delT

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BRCA-1, BRCA-2

• ???? ?????? ?????? DNA
• ?????? ?? ?? ?????? BRCA1 ??? ??????? ?????????
  ????????
• ??????? ?????? ?????? ??????? ?? ????????
• ?????? ??? ?? ?? 51RAD
• ?????? ??????? ?-RAD51 ?????? ???????? ?? BRCA2
  ????? ????? ?? ?? ?? ????? ????

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CA 15-3

• ????? ???????????? ??? ???? ???????? ???? ??????
  ???????? ?????? ???? ????? ??
• ???? ???? ?? ?????? ?????? ????? ?????????? ??
  ????????
• ???? ?????? ???? ?? ??????
• ???? ????? ????, ?? ????? ???? ?????? ???? ???
  ??????? ?? ?????? ?? ?????????

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????? ???? ??????? ?? Ca 15-3

• ????? ??????? ?????, ????? ?? ????, ???? ????
• ????? ???? ???, ???????, ???????, ??????? ?????
• ????? ????, ????? ???? ?????

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???? ????

• ??????? ??????????? ?????? ????????? ????? ?? ???
  ??? ????? ??????? ?- 90 ??????? ??????
• ??? ??? ???? ??? ???????? ??????? ???????? ????
  ?? ???? ????? ?????? ?????? ????????? ??? ??
  ?????? ???? ???? ???????
• ?????? ??? ??? ???????? ????? ???? ????
• ?????? ??????

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CA 125