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中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (3): 305-311.doi: 10.3969/j.issn.1674-5671.2025.03.07

• 其他消化系统肿瘤专栏 • 上一篇    下一篇

结直肠癌防治的最新进展:从精准筛查到个体化治疗

  

  1. 广西医科大学附属肿瘤医院胃肠外科结直肠肛门病区;广西结直肠癌基础与转化研究重点实验室;广西壮族自治区卫生健康委员会结直肠癌防治重点实验室;广西壮族自治区肿瘤分子医学工程研究中心
  • 出版日期:2025-06-25 发布日期:2025-07-10
  • 通讯作者: 唐卫中 E-mail:tangweizhong@gxmu.edu.cn
  • 基金资助:
    国家自然科学基金项目(82460610);广西自然科学基金项目(2025GXNSFAA069662)

Recent advances in the prevention and treatment of colorectal cancer: From precision screening to personalized therapy

  • Online:2025-06-25 Published:2025-07-10

摘要: 结直肠癌(colorectal cancer,CRC)作为全球第三大常见恶性肿瘤,其防治体系已取得显著进展。在早期检测方面,人工智能技术的应用显著提升了筛查效率,弥补了传统侵入性诊断技术的不足。在治疗领域,经肛门全直肠系膜切除术有助于实现器官功能保留,而全程新辅助治疗策略显著促进了局部晚期患者的肿瘤消退和病理降期。免疫治疗为错配修复缺陷或微卫星高度不稳定的CRC患者带来长期生存获益。此外,新型靶向治疗显著提高了晚期CRC患者的客观缓解率与临床获益率。目前,CRC防治已迈入精准外科与多维度诊疗整合的新阶段。本文系统回顾了CRC防治领域的最新重要研究进展,特别关注早期筛查与诊断技术的创新,精准预防策略,微创外科手术的进步,新辅助治疗方案的优化,以及转移性CRC个体化治疗的突破,旨在为临床实践提供决策参考,并为未来的研究方向奠定理论基础。

关键词: 结直肠癌, 筛查诊断, 新辅助治疗, 个体化治疗

Abstract: Colorectal cancer (CRC), identified as the third most prevalent malignant tumor worldwide, has achieved substantial progress in its prevention and treatment paradigms. In the field of early detection, the implementation of artificial intelligence technology has markedly enhanced screening efficiency, addressing the limitations inherent in traditional invasive diagnostic methods. On the therapeutic front, transanal total mesorectal excision has facilitated the preservation of organ function, while total neoadjuvant therapy strategies have notably improved tumor regression and pathological downstaging in locally advanced CRC. Immunotherapy has conferred long⁃term survival benefits for CRC patients exhibiting deficient mismatch repair or high microsatellite instability. Additionally, novel targeted therapies  have significantly elevated both  the objective response rate and clinical benefit rate for patients with advanced CRC. The current landscape of CRC prevention has entered a new phase, characterized by the integration of precision surgery with multidimensional diagnostic and therapeutic approaches. This article provides a systematic review of recent significant research advance ments in CRC, with an emphasis on innovations in early screening and diagnosis, precise prevention strategies, advancements in minimally invasive surgical techniques, optimization of neoadjuvant treatment regimens, and breakthroughs in personalized treatment for metastatic CRC prevention and treatment. The aimis to offer decision⁃making references for clinical practice and establish theoretical foundations for future research directions.

Key words: Colorectal cancer, Screening and diagnosis, Neoadjuvant therapy, Personalized therapy

中图分类号: 

  • R735.3