非转移性结直肠癌预后预测体系的研究进展与挑战  

Advances and Challenges in Prognosis Prediction Systems for Non-metastatic Colorectal Cancer

作　　者：孔祥兴[1] 李军[1] KONG Xiangxing;LI Jun(Department of Colorectal Surgery and Oncology,Key Laboratory of Cancer Prevention and Intervention,Ministry of Education,The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院大肠外科,恶性肿瘤预警与干预教育部重点实验室,杭州310009

出　　处：《肿瘤防治研究》2020年第12期919-924,共6页Cancer Research on Prevention and Treatment

基　　金：国家自然基金面上项目(81672916);浙江省重点研发计划(2017C03017)。

摘　　要：结直肠癌是世界范围内常见的恶性肿瘤之一,其中无远处转移的患者预后较好。然而,这类患者中仍存在具有复发风险的高危患者。因此,准确地对患者进行预后预测并提供进一步治疗方案,是提升结直肠癌临床治愈率的关键。TNM分期作为临床广泛应用的预后预测体系存在一定局限性:该系统仅纳入三个指标,并采用简单的线性方法对患者进行分类,忽视了患者预后作为复杂非线性现象存在的客观性;同时,该体系也从未对新近发现的预后预测指标,如患者的临床信息、病理信息、分子标志物和免疫状态标志物进行整合改良。我们推测,以上信息可能作为补充因素与传统的预后预测系统结合,从而提高预后评估的准确度。本文系统回顾了这一领域的研究进展,并提出了建立新一代非转移性结直肠癌预后预测系统的可能途径。Colorectal cancer is one of the most common malignancies in the world,and patients without distant metastasis have a better prognosis.As some patients in this group are still at high risk of recurrence,accurate prognosis prediction and further treatment are the keys to improve the clinical cure rate of colorectal cancer.TNM staging,a widely used prognostic system in clinical practice,has some limitations:the system only includes three indicators,and uses a simple linear method to classify patients,while ignoring the objectivity of prognosis as a complex nonlinear phenomenon.At the same time,the system has never integrated or improved the newly discovered prognostic indicators,like clinical information,pathological information,molecular markers and immune markers.We speculate the above information may be used as supplementary factors to combine with the traditional prognosis prediction system,so as to improve the accuracy of prognosis assessment.This article systematically reviews the research progress in this field and proposes a possible way to build a new generation of prognosis prediction system for non-metastatic colorectal cancer.

关 键 词：结直肠癌 非转移性 预后 预测 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]