结直肠癌的分子分型与精准治疗策略:从经验到精确
Molecular typing and precise treatment strategies for colorectal cancer: from experience to precision
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摘要: 以结直肠癌为代表的消化道恶性肿瘤,具有独特的临床特征及生物学行为,在我国发病率及病死率位居前列。近年来,随着科技的创新及疾病管理模式的不断优化,“精准外科”理念不断推动结直肠癌外科从传统经验外科范式向现代精准外科范式转变,结直肠外科治疗取得飞速发展,包括手术技术、器械平台、多种新型靶向治疗及免疫联合治疗等在结直肠癌治疗中成效明显。同时,随着我国腹腔镜结直肠外科发展30年,结直肠癌手术方式已从传统开腹转变为微创手术,结直肠癌患者的诊断与治疗模式也逐步从过去的经验为导向,变迁为精准化、个体化。笔者以“精准外科”理念为导向,结合结直肠癌外科的发展现状及趋势,探讨相关分子分型与精准治疗策略,从而促进结直肠癌的精准手术与综合治疗。Abstract: Represented by colorectal cancer, gastrointestinal malignancies have unique clinical characteristics and biological behaviors, ranking high in the incidence and mortality rates in China. In recent years, with technological innovations and continuous optimization of disease management models, the concept of "precision surgery" has been driving the transformation of colorectal cancer surgery from traditional empirical surgical paradigms to modern precision surgical paradigms. Rapid advancements have been made in colorectal surgical treatment, including surgical techniques, instrument platforms, various novel targeted therapies, and immune combination therapies, which have demonstrated significant efficacy in colorectal cancer treatment. Meanwhile, with 30 years of development in laparoscopic colorectal surgery in China, the surgical approach for colorectal cancer has shifted from traditional open‑bellied surgery to minimally invasive surgery. The diagnostic and therapeutic models for colorectal cancer patients have gradually transitioned from experience‑driven to precision‑based and individualized care. Guided by the concept of "precision surgery", this article combines the current status and trends in colorectal cancer surgery to discuss relevant molecular subtyping and precision treatment strategies, aiming to promote precise surgery and comprehensive treatment for colorectal cancer.