微小残留病灶在非转移性结直肠癌中的应用研究进展  

Advances in the application of minimal residual disease in non-metastatic colorectal cancer

作　　者：曹玓 王芳[2] 张荣欣[1] 魏冰 何明彦 彭俊杰 陈功[1] Cao Di;Wang Fang;Zhang Rongxin;Wei Bing;He Mingyan;Peng Junjie;Chen Gong(Department of Colorectal Surgery,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center of Cancer Medicine,Guangzhou 510060,China;Department of Molecular Diagnosis,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center of Cancer Medicine,Guangzhou 510060,China;Department of Molecular Pathology,The Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450003,China;Department of Colorectal Surgery,Gansu Provincial Cancer Hospital,Gansu Hospital of Sun Yat-sen University Cancer Center,Lanzhou 730050,China;Department of Colorectal Surgery,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]中山大学肿瘤防治中心结直肠科,华南肿瘤学国家重点实验室,肿瘤医学省部共建协同创新中心,广州510060 [2]中山大学肿瘤防治中心分子诊断科,华南肿瘤学国家重点实验室,肿瘤医学省部共建协同创新中心,广州510060 [3]郑州大学附属肿瘤医院分子病理科,郑州450003 [4]中山大学附属肿瘤医院甘肃医院,甘肃省肿瘤医院结直肠外科,兰州730050 [5]复旦大学附属肿瘤医院大肠外科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中华胃肠外科杂志》2024年第7期749-755,共7页Chinese Journal of Gastrointestinal Surgery

基　　金：广东省基础与应用基础研究基金(2023A1515010243);中国临床肿瘤学会基金(Y-HR2018-319、Y-L2017-002、Y-JS2019-009);广州医科大学附属第六医院、清远市人民医院开放研究基金(202301-314);中山大学5010研究基金(2015024)。

摘　　要：近年来,微小残留病灶(MRD)在实体瘤中的应用受到广泛关注,一般是指在接受根治性治疗,如手术切除等手段后影像学无法发现的残留癌灶,术后MRD阳性状态与肿瘤复发风险升高明显相关。在结直肠癌中,循环肿瘤DNA(ctDNA)是评估MRD的有效标志物,其在非转移性(Ⅰ~Ⅲ期)结直肠癌中的应用尤为重要,作为一种实时、准确和便捷的生物标志物,能够有效预警肿瘤复发,指导术后辅助化疗决策,并为复发监测提供重要信息。ctDNA检测技术的应用前景广阔,有望为结直肠癌患者带来更为精准的个体化治疗方案。本文综合分析了ctDNA在检测非转移性结直肠癌患者MRD中的应用进展,详细探讨并梳理了其在临床治疗决策中的指导作用,同时展望了该领域的未来发展方向。In recent years,the application of minimal residual disease(MRD)in solid tumors has gained widespread attention.MRD typically refers to the presence of residual cancer cells that remain undetectable by imaging after curative treatments,such as surgical resection.The presence of MRD post-surgery is significantly associated with an increased risk of tumor recurrence.In colorectal cancer,circulating tumor DNA(ctDNA)serves as an effective marker for assessing MRD,particularly in non-metastatic(stages I-III)colorectal cancer.As a real-time,accurate,and convenient biomarker,ctDNA can effectively predict tumor recurrence,guide postoperative adjuvant chemotherapy decisions,and provide crucial information for recurrence monitoring.The application prospects of ctDNA detection technology are vast,promising more precise and individualized treatment plans for colorectal cancer patients.This article comprehensively analyzes the progress in the application of ctDNA for detecting MRD in non-metastatic colorectal cancer patients,elaborates on its guiding role in clinical treatment decisions,and envisions the future development directions in this field.

关 键 词：结直肠肿瘤 非转移性 循环肿瘤DNA 微小残留病灶 精准医疗 

分 类 号：R735.34[医药卫生—肿瘤]