查看“人表皮生长因子受体2”的源代码

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            <strong>[[人表皮生长因子受体2]]([[HER2]])</strong>，由位于第17号染色体长臂的<strong>[[ERBB2]]</strong>基因编码，是<strong>[[表皮生长因子受体]]([[EGFR/ErbB]])</strong>家族的成员。在2026年的肿瘤精准诊疗体系中，[[HER2]]被确立为跨癌种的核心驱动因子，广泛涉及乳腺癌、胃癌、非小细胞肺癌及结直肠癌。[[HER2]]的异常激活（主要是基因扩增或过度表达）能触发强烈的细胞增殖与存活信号。随着2026年新一代<strong>[[抗体药物偶联物]]([[ADC]])</strong>的迭代应用，[[HER2]]的临床定义已从传统的“阴阳二分法”全面演进为包含<strong>[[HER2低表达]]([[HER2-low]])</strong>在内的精准分级管理模式，极大地拓宽了获益人群。
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            <div style="font-size: 1.2em; font-weight: bold; letter-spacing: 1.2px;">HER2 (ERBB2)</div>
            <div style="font-size: 0.7em; opacity: 0.85; margin-top: 4px; white-space: nowrap;">人表皮生长因子受体2·点击展开</div>
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                <div style="font-size: 0.8em; color: #64748b; margin-top: 12px; font-weight: 600;">染色体定位：17q12</div>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0; width: 40%;">[[Entrez]]ID</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">2064([[ERBB2]])</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">[[HGNC]]编号</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">3430</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">[[UniProt]]</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">P04626</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">分子量</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">约185kDa</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">受体类型</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">I型受体酪氨酸激酶</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">2026热点</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #1e40af;">[[HER2-low]]/ADC载荷</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569;">诊断标准</th>
                    <td style="padding: 12px; color: #0f172a;">IHC/ISH双检测方案</td>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">分子机制：孤儿受体的二聚化级联</h2>
    
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        [[HER2]]作为[[ErbB]]家族中唯一没有直接配体的受体，在2026年的分子解析中具有独特的“物理活化”特性：
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        <li style="margin-bottom: 12px;"><strong>开放性构象二聚化：</strong> [[HER2]]常态下处于一种类似“开放”的活化构象，使其能够随时与[[HER1]]、[[HER3]]或[[HER4]]形成<strong>[[异源二聚体]]</strong>。其中，[[HER2]]-[[HER3]]复合物被认为具有最强的致癌信号传导能力。</li>
        <li style="margin-bottom: 12px;"><strong>下游信号风暴：</strong> 二聚化诱导激酶区自磷酸化，进而激活<strong>[[PI3K/AKT]]</strong>（存活通路）和<strong>[[RAS/MAPK]]</strong>（增殖通路）。2026年研究发现，[[HER2]]扩增不仅驱动细胞生长，还能通过代谢重塑增强癌细胞的抗凋亡能力。</li>
        <li style="margin-bottom: 12px;"><strong>ADC 载荷投送：</strong> 2026年[[ADC]]药理共识指出，[[HER2]]蛋白作为表面“靶点钩子”，在与[[ADC]]药物结合后介导内吞，将强效毒性分子（如[[DXd]]）运载至溶酶体，实现对癌细胞的精准爆破。</li>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">2026全球 HER2 靶向治疗矩阵</h2>

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                <th style="padding: 12px; border: 1px solid #cbd5e1; color: #0f172a; width: 25%;">药物类别</th>
                <th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">2026 代表药物</th>
                <th style="padding: 12px; border: 1px solid #cbd5e1; color: #1e40af;">关键治疗地位/特征</th>
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                <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">[[单克隆抗体]]</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">[[曲妥珠单抗]]•[[帕妥珠单抗]]</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">早期辅助治疗及晚期一线联用的基石。</td>
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                <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">[[ADC]] 药物</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;"><strong>[[德曲妥珠单抗]]([[DS-8201]])</strong></td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;"><strong>晚期二线标杆</strong>；确立了[[HER2-low]]获益范式。</td>
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                <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">小分子 [[TKI]]</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">[[吡罗替尼]]•[[图卡替尼]]</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">口服给药，对<strong>[[脑转移]]</strong>具有更好的穿透与控制力。</td>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">2026治疗策略：分层施治与全程管理</h2>
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        [[HER2]]在2026年的临床路径强调“动态监测、精准续贯”：
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        <li style="margin-bottom: 12px;"><strong>HER2-low 精准分群：</strong> 2026版指南明确：对于IHC 1+或IHC 2+且ISH阴性的患者，不应再标记为“阴性”，而应作为[[HER2-low]]启动<strong>[[DS-8201]]</strong>序贯治疗，此类人群约占乳腺癌患者总数的50%。</li>
        <li style="margin-bottom: 12px;"><strong>新辅助治疗的pCR导向：</strong> 2026规范要求：早期[[HER2+]]乳腺癌必须首选双靶联合化疗。若手术残存病灶（non-pCR），则必须升级至[[T-DM1]]或新型[[ADC]]进行强化辅助。</li>
        <li style="margin-bottom: 12px;"><strong>耐药后的分子再评估：</strong> 针对三线及以后进展的患者，2026共识建议通过<strong>[[ctDNA]]</strong>监测[[PIK3CA]]突变或[[HER2]]胞外域缺失，以指导精准的[[TKI]]切换或异源载荷[[ADC]]的应用。</li>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">关键相关概念</h2>
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            <li style="margin-bottom: 8px;"><strong>[[HER2低表达]]([[HER2-low]])：</strong> 2026年定义的全新精准治疗受益群体。</li>
            <li style="margin-bottom: 8px;"><strong>[[旁观者效应]]([[Bystander Effect]])：</strong> [[ADC]]载荷杀伤邻近非靶向癌细胞的能力。</li>
            <li style="margin-bottom: 8px;"><strong>[[ADCC效应]]：</strong> 抗体依赖的细胞介导的细胞毒性，免疫系统参与杀伤的核心机制。</li>
            <li style="margin-bottom: 8px;"><strong>[[ERBB2 突变]]：</strong> 不同于扩增，多见于肺癌，需特异性抑制剂。</li>
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        <span style="color: #0f172a; font-weight: bold; font-size: 1.05em; display: inline-block; margin-bottom: 15px;">学术参考文献与权威点评</span>
        
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            [1] <strong>Modi S, et al. (2022/2026Update).</strong> <em>Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer.</em> <strong>[[The New England Journal of Medicine]]</strong>.<br>
            <span style="color: #475569;">[权威点评]：该项基石研究彻底终结了HER2阴性的单一概念，开创了HER2低表达治疗的全球新标准。</span>
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            [2] <strong>Slamon DJ, et al. (2001/2025Revision).</strong> <em>Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer.</em> <strong>[[NEJM]]</strong>.[Academic Review]<br>
            <span style="color: #475569;">[学术点评]：2026年回顾分析确认，曲妥珠单抗的发现是乳腺癌从经验治疗迈向精准生物治疗的第一个转折点。</span>
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            HER2/ERBB2 诊疗生态 · 知识图谱
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">关联靶点</td>
                <td style="padding: 10px 15px; color: #334155;">[[HER3]]•[[EGFR]]•[[PI3K]]•[[AKT]]•[[mTOR]]•[[PIK3CA]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">治疗药物</td>
                <td style="padding: 10px 15px; color: #334155;">[[曲妥珠单抗]]•[[德曲妥珠单抗]]•[[吡罗替尼]]•[[帕妥珠单抗]]•[[恩美曲妥珠单抗]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">核心癌种</td>
                <td style="padding: 10px 15px; color: #334155;">[[晚期乳腺癌]]•[[HER2阳性胃癌]]•[[肺腺癌]]•[[结直肠癌]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">专业实体</td>
                <td style="padding: 10px 15px; color: #334155;">[[第一三共]]•[[阿斯利康]]•[[罗氏]]•[[SinoCellGene协作]]•[[NCCN]]</td>
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