MSI-H/dMMR亚组局部晚期结直肠癌患者新辅助免疫治疗研究进展  

Research progress on neoadjuvant immunotherapy for MSI-H/dMMR subtype patients with locally advanced colorectal cancer

作　　者：刘汉清 孙银萍[2] 赵强[2] 任帅 Liu Hanqing;Sun Yinping;Zhao Qiang;Ren Shuai(Binzhou Medical University,Binzhou 256600,China;Zibo Central Hospital,Zibo 250036,China)

机构地区：[1]滨州医学院,滨州256600 [2]淄博市中心医院,淄博250036

出　　处：《国际医药卫生导报》2025年第8期1270-1274,共5页International Medicine and Health Guidance News

基　　金：国家中医药管理局科技司-山东省卫生健康委员会共建中医药科技项目(GZY-KJS-SD-2023-010);山东省中医药科技项目(Z-2022013);北京科创医学发展基金会科技项目(KC2023-JX-0288-PM91);山东省自然科学基金青年项目(ZR2022QH392);淄博市卫生健康青年卓越人才孵站培养基金(202210)。

摘　　要：近年来,全程新辅助治疗广泛应用于局部晚期结直肠癌(locally advanced colorectal cancer,LACRC)患者的治疗,显著提高了患者术前肿瘤消退率,降低了术后局部区域复发风险。新辅助免疫治疗在LACRC患者中的应用取得了良好的临床效果。新辅助免疫治疗单用或联合新辅助放化疗续贯手术治疗成为了LACRC患者新的治疗方式。根据错配修复蛋白表达,结直肠癌(colorectal cancer,CRC)可分为微卫星高度不稳定/错配修复功能缺陷(microsatellite hyperinstability/mismatch repair functional defects,MSI-H/dMMR)和非微卫星高度不稳定/错配修复功能完整(non-microsatellite high instability/mismatch repair is complete,非MSI-H/pMMR)2个亚组。MSI-H/dMMR亚组患者从放化疗中取得的临床获益有限,但由于其肿瘤组织中免疫细胞浸润丰富,可以从免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)治疗中获得良好的效果。本文对新辅助免疫治疗在MSI-H/dMMR亚组LACRC患者中的临床应用进行综述,讨论其治疗LACRC患者的优势,为LACRC患者术前新辅助治疗提供参考。In recent years,neoadjuvant therapy is widely used in the treatment of locally advanced colorectal cancer(LACRC),and has significantly improved the preoperative tumor regression rate and reduced the risk of postoperative local recurrence.Neoadjuvant immunotherapy has achieved favorable clinical effects in the treatment of LACRC.Neoadjuvant immunotherapy with or without neoadjuvant chemoradiotherapy followed by surgery had become a new therapeutic method for LACRC.Based on the expression of mismatch repair proteins,colorectal cancer(CRC)can be divided into two subgroups:microsatellite highly unstable/mismatch repair dysfunction(MSI-H/dMMR)and non-microsatellite highly unstable/mismatch repair function complete(non-MSI-H/pMMR).MSI-H/dMMR patients obtain limited clinical benefits from chemoradiotherapy,but have favorable clinical effects in immune checkpoint inhibitors(ICIs)treatment due to the abundant immune cell infiltration.This article reviews and discusses the clinical application and advantages of neoadjuvant immunotherapy in MSI-H/dMMR LACRC patients,so as to provide references for the preoperative neoadjuvant treatment for LACRC.

关 键 词：局部晚期结直肠癌 新辅助免疫治疗 错配修复功能缺陷 微卫星高度不稳定 进展 

分 类 号：R735.3[医药卫生—肿瘤]