结肠癌治疗的研究进展
Research Progress in the Treatment of Colon Cancer
DOI: 10.12677/acm.2025.15102776, PDF,   
作者: 侯文宇, 王 强*:内蒙古民族大学第二临床医学院(内蒙古林业总医院),内蒙古 牙克石
关键词: 结肠癌肿瘤治疗Colon Cancer Tumor Treatment
摘要: 近几年,结肠癌作为全球第三大常见癌症,在治疗领域取得了显著进展,本文将基于2025年发布的研究成果,其中涵盖了手术技术、化疗、靶向治疗、免疫治疗以及个体化治疗等多个方面。本文通过总结结肠癌在治疗方面的进展,目的是为以后的临床研究和未来发展提供参考。
Abstract: In recent years, colorectal cancer, as the third most common cancer globally, has made significant progress in the field of treatment. This article is based on research findings released in 2025, covering various aspects such as surgical techniques, chemotherapy, targeted therapy, immunotherapy, and personalized treatment. By summarizing the advancements in the treatment of colorectal cancer, the aim is to provide a reference for future clinical research and development.
文章引用:侯文宇, 王强. 结肠癌治疗的研究进展[J]. 临床医学进展, 2025, 15(10): 446-453. https://doi.org/10.12677/acm.2025.15102776

参考文献

[1] Rondelli, F., Balzarotti, R., Villa, F., Guerra, A., Avenia, N., Mariani, E., et al. (2015) Is Robot-Assisted Laparoscopic Right Colectomy More Effective than the Conventional Laparoscopic Procedure? A Meta-Analysis of Short-Term Outcomes. International Journal of Surgery, 18, 75-82. [Google Scholar] [CrossRef] [PubMed]
[2] Prete, F.P., Pezzolla, A., Prete, F., Testini, M., Marzaioli, R., Patriti, A., et al. (2018) Robotic versus Laparoscopic Minimally Invasive Surgery for Rectal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Annals of Surgery, 267, 1034-1046. [Google Scholar] [CrossRef] [PubMed]
[3] Quezada-Diaz, F.F. and Smith, J.J. (2023) Colon Cancer: Is the Robot a Better Option? Annals of Laparoscopic and Endoscopic Surgery, 8, Article 35. [Google Scholar] [CrossRef
[4] Martínez-Pérez, A., Reitano, E., Gavriilidis, P., Genova, P., Moroni, P., Memeo, R., et al. (2019) What Is the Best Surgical Option for the Resection of Transverse Colon Cancer? Annals of Laparoscopic and Endoscopic Surgery, 4, Article 69. [Google Scholar] [CrossRef
[5] Milone, M., Manigrasso, M., Elmore, U., Maione, F., Gennarelli, N., Rondelli, F., et al. (2018) Short-and Long-Term Outcomes after Transverse versus Extended Colectomy for Transverse Colon Cancer. A Systematic Review and Meta-Analysis. International Journal of Colorectal Disease, 34, 201-207. [Google Scholar] [CrossRef] [PubMed]
[6] Isik, O. and Gorgun, E. (2015) How Has the Robot Contributed to Colon Cancer Surgery? Clinics in Colon and Rectal Surgery, 28, 220-227. [Google Scholar] [CrossRef] [PubMed]
[7] Negrut, R.L., Cote, A., Caus, V.A. and Maghiar, A.M. (2024) Systematic Review and Meta-Analysis of Laparoscopic versus Robotic-Assisted Surgery for Colon Cancer: Efficacy, Safety, and Outcomes—A Focus on Studies from 2020-2024. Cancers, 16, Article 1552. [Google Scholar] [CrossRef] [PubMed]
[8] Kim, K.E., Jeong, W.K., Baek, S.K. and Bae, S.U. (2025) Robot-Assisted Colectomy for Left‐Sided Colon Cancer: Comparison of Da Vinci SP and Single‐Site Platforms. The International Journal of Medical Robotics and Computer Assisted Surgery, 21, e70079. [Google Scholar] [CrossRef] [PubMed]
[9] Xu, S., Liu, K., Chen, X. and Yao, H. (2021) The Safety and Efficacy of Laparoscopic Surgery versus Laparoscopic NOSE for Sigmoid and Rectal Cancer. Surgical Endoscopy, 36, 222-235. [Google Scholar] [CrossRef] [PubMed]
[10] Chen, M.Z., Cartmill, J. and Gilmore, A. (2020) Natural Orifice Specimen Extraction for Colorectal Surgery: Early Adoption in a Western Population. Colorectal Disease, 23, 937-943. [Google Scholar] [CrossRef] [PubMed]
[11] Lu, Z., Chen, H., Zhang, M., Guan, X., Zhao, Z., Jiang, Z., et al. (2020) Safety and Survival Outcomes of Transanal Natural Orifice Specimen Extraction Using Prolapsing Technique for Patients with Middle-to Low-Rectal Cancer. Chinese Journal of Cancer Research, 32, 654-664. [Google Scholar] [CrossRef] [PubMed]
[12] Bu, J., Li, N., He, S. et al. (2020) Effect of Laparoscopic Surgery for Colorectal Cancer with Recovery and Prognosis of Patients. Minimally Invasive Therapy & Allied Technologies. MITAT.
[13] Hisada, M. (2014) Complete Laparoscopic Resection of the Rectum Using Natural Orifice Specimen Extraction. World Journal of Gastroenterology, 20, 16707-16713. [Google Scholar] [CrossRef] [PubMed]
[14] Zhou, S., Wang, X., Zhao, C., Wei, P., Zhou, H., Liu, Q., et al. (2019) Comparison of Short-Term and Survival Outcomes for Transanal Natural Orifice Specimen Extraction with Conventional Mini-Laparotomy after Laparoscopic Anterior Resection for Colorectal Cancer. Cancer Management and Research, 11, 5939-5948. [Google Scholar] [CrossRef] [PubMed]
[15] Zhang, H., Hu, H., Huang, R., Guan, Z., Zheng, M., Xu, C., et al. (2021) Natural Orifice Specimen Extraction Surgery versus Conventional Laparoscopic-Assisted Resection for Colorectal Cancer in Elderly Patients: A Propensity-Score Matching Study. Updates in Surgery, 74, 599-607. [Google Scholar] [CrossRef] [PubMed]
[16] Efetov, S.K., Cao, Y., Panova, P.D., Khlusov, D.I. and Shulutko, A.M. (2024) Reduced-Port Laparoscopic Right Colonic Resection with D3 Lymph Node Dissection and Transvaginal Specimen Extraction (NOSES Viiia) for Right Colon Cancer: Clinical Features. Techniques in Coloproctology, 29, Article No. 34. [Google Scholar] [CrossRef] [PubMed]
[17] FOxTROT Collaborating Group (2023) Risk of Bowel Obstruction in Patients Undergoing Neoadjuvant Chemotherapy for High-Risk Colon Cancer: A Nested Case-Control-Matched Analysis of an International, Multicenter, Randomized Controlled Trial (FOxTROT). Annals of Surgery, 280, 283-293. [Google Scholar] [CrossRef] [PubMed]
[18] Morton, D., Seymour, M., Magill, L., Handley, K., Glasbey, J., Glimelius, B., et al. (2023) Preoperative Chemotherapy for Operable Colon Cancer: Mature Results of an International Randomized Controlled Trial. Journal of Clinical Oncology, 41, 1541-1552. [Google Scholar] [CrossRef] [PubMed]
[19] Hu, H., Zhang, J., Li, Y., Wang, X., Wang, Z., Wang, H., et al. (2024) Neoadjuvant Chemotherapy with Oxaliplatin and Fluoropyrimidine versus Upfront Surgery for Locally Advanced Colon Cancer: The Randomized, Phase III OPTICAL Trial. Journal of Clinical Oncology, 42, 2978-2988. [Google Scholar] [CrossRef] [PubMed]
[20] Lu, D., Dong, C., Wang, K., Ye, C., Chen, L., Yuan, Y., et al. (2025) Updates of CSCO Guidelines for Colorectal Cancer Version 2025. Chinese Journal of Cancer Research, 37, 297-302. [Google Scholar] [CrossRef] [PubMed]
[21] Shalhout, S.Z., Miller, D.M., Emerick, K.S. and Kaufman, H.L. (2023) Therapy with Oncolytic Viruses: Progress and Challenges. Nature Reviews Clinical Oncology, 20, 160-177. [Google Scholar] [CrossRef] [PubMed]
[22] Bell, J.C. (2020) Check and Checkmate: Battling Cancer with Multiplex Immunotherapy. Molecular Therapy, 28, 1236-1237. [Google Scholar] [CrossRef] [PubMed]
[23] Bourhill, T., Mori, Y., Rancourt, D., Shmulevitz, M. and Johnston, R. (2018) Going (Reo)viral: Factors Promoting Successful Reoviral Oncolytic Infection. Viruses, 10, Article 421. [Google Scholar] [CrossRef] [PubMed]
[24] Kim, M., Nitschké, M., Sennino, B., Murer, P., Schriver, B.J., Bell, A., et al. (2018) Amplification of Oncolytic Vaccinia Virus Widespread Tumor Cell Killing by Sunitinib through Multiple Mechanisms. Cancer Research, 78, 922-937. [Google Scholar] [CrossRef] [PubMed]
[25] Oh, C., Chon, H.J. and Kim, C. (2020) Combination Immunotherapy Using Oncolytic Virus for the Treatment of Advanced Solid Tumors. International Journal of Molecular Sciences, 21, Article 7743. [Google Scholar] [CrossRef] [PubMed]
[26] Kim, M., Garant, K.A., zur Nieden, N.I., Alain, T., Loken, S.D., Urbanski, S.J., et al. (2010) Attenuated Reovirus Displays Oncolysis with Reduced Host Toxicity. British Journal of Cancer, 104, 290-299. [Google Scholar] [CrossRef] [PubMed]
[27] Kelly, K., Nawrocki, S., Mita, A., Coffey, M., Giles, F.J. and Mita, M. (2009) Reovirus-Based Therapy for Cancer. Expert Opinion on Biological Therapy, 9, 817-830. [Google Scholar] [CrossRef] [PubMed]
[28] Kim, M., Chung, Y.H. and Johnston, R.N. (2007) Reovirus and Tumor Oncolysis. Journal of Microbiology, 45, 187-192.
[29] Goubau, D., Schlee, M., Deddouche, S., Pruijssers, A.J., Zillinger, T., Goldeck, M., et al. (2014) Antiviral Immunity via Rig-I-Mediated Recognition of RNA Bearing 5’-Diphosphates. Nature, 514, 372-375. [Google Scholar] [CrossRef] [PubMed]
[30] Loo, Y., Fornek, J., Crochet, N., Bajwa, G., Perwitasari, O., Martinez-Sobrido, L., et al. (2008) Distinct RIG-I and MDA5 Signaling by RNA Viruses in Innate Immunity. Journal of Virology, 82, 335-345. [Google Scholar] [CrossRef] [PubMed]
[31] Clarke, P., Meintzer, S.M., Gibson, S., Widmann, C., Garrington, T.P., Johnson, G.L., et al. (2000) Reovirus-Induced Apoptosis Is Mediated by Trail. Journal of Virology, 74, 8135-8139. [Google Scholar] [CrossRef] [PubMed]
[32] Kominsky, D.J., Bickel, R.J. and Tyler, K.L. (2002) Reovirus-Induced Apoptosis Requires Both Death Receptor-and Mitochondrial-Mediated Caspase-Dependent Pathways of Cell Death. Cell Death & Differentiation, 9, 926-933. [Google Scholar] [CrossRef] [PubMed]
[33] Lee, W.S., Lee, S.J., Lee, H.J., Yang, H., Go, E., Gansukh, E., et al. (2024) Oral Reovirus Reshapes the Gut Microbiome and Enhances Antitumor Immunity in Colon Cancer. Nature Communications, 15, Article No. 9092. [Google Scholar] [CrossRef] [PubMed]
[34] Li, Q., Wang, Y., Tu, J., Liu, C., Yuan, Y., Lin, R., et al. (2020) Anti-EGFR Therapy in Metastatic Colorectal Cancer: Mechanisms and Potential Regimens of Drug Resistance. Gastroenterology Report, 8, 179-191. [Google Scholar] [CrossRef] [PubMed]
[35] You, K.S., Yi, Y.W., Cho, J., Park, J. and Seong, Y. (2021) Potentiating Therapeutic Effects of Epidermal Growth Factor Receptor Inhibition in Triple-Negative Breast Cancer. Pharmaceuticals, 14, Article 589. [Google Scholar] [CrossRef] [PubMed]
[36] Seligmann, J.F., Elliott, F., Richman, S.D., Jacobs, B., Hemmings, G., Brown, S., et al. (2016) Combined Epiregulin and Amphiregulin Expression Levels as a Predictive Biomarker for Panitumumab Therapy Benefit or Lack of Benefit in Patients with RAS Wild-Type Advanced Colorectal Cancer. JAMA Oncology, 2, 633-642. [Google Scholar] [CrossRef] [PubMed]
[37] Baker, J.B., Dutta, D., Watson, D., Maddala, T., Munneke, B.M., Shak, S., et al. (2011) Tumour Gene Expression Predicts Response to Cetuximab in Patients with KRAS Wild-Type Metastatic Colorectal Cancer. British Journal of Cancer, 104, 488-495. [Google Scholar] [CrossRef] [PubMed]
[38] Khambata-Ford, S., Garrett, C.R., Meropol, N.J., Basik, M., Harbison, C.T., Wu, S., et al. (2007) Expression of Epiregulin and Amphiregulin and K-RAS Mutation Status Predict Disease Control in Metastatic Colorectal Cancer Patients Treated with Cetuximab. Journal of Clinical Oncology, 25, 3230-3237. [Google Scholar] [CrossRef] [PubMed]
[39] Vale, C.L., Tierney, J.F., Fisher, D., Adams, R.A., Kaplan, R., Maughan, T.S., et al. (2012) Does Anti-EGFR Therapy Improve Outcome in Advanced Colorectal Cancer? a Systematic Review and Meta-Analysis. Cancer Treatment Reviews, 38, 618-625. [Google Scholar] [CrossRef] [PubMed]
[40] Douillard, J., Oliner, K.S., Siena, S., Tabernero, J., Burkes, R., Barugel, M., et al. (2013) Panitumumab-FOLFOX4 Treatment and RAS Mutations in Colorectal Cancer. New England Journal of Medicine, 369, 1023-1034. [Google Scholar] [CrossRef] [PubMed]
[41] Seymour, M.T., Brown, S.R., Middleton, G., Maughan, T., Richman, S., Gwyther, S., et al. (2013) Panitumumab and Irinotecan versus Irinotecan Alone for Patients with KRAS Wild-Type, Fluorouracil-Resistant Advanced Colorectal Cancer (PICCOLO): A Prospectively Stratified Randomised Trial. The Lancet Oncology, 14, 749-759. [Google Scholar] [CrossRef] [PubMed]
[42] High, P.C., Liang, Z., Guernsey-Biddle, C., et al. (2025) Cetuximab Increases LGR5 Expression and Augments LGR5-Targeting Anti-Body-Drug Conjugate Efficacy in Patient-Derived Colorectal Cancer Models. bioRxiv. [Google Scholar] [CrossRef] [PubMed]
[43] Tâlvan, C., Budișan, L., Tâlvan, E., Grecu, V., Zănoagă, O., Mihalache, C., et al. (2024) Serum Interleukins 8, 17, and 33 as Potential Biomarkers of Colon Cancer. Cancers, 16, Article 745. [Google Scholar] [CrossRef] [PubMed]
[44] Antoniotti, C., Borelli, B., Rossini, D., Pietrantonio, F., Morano, F., Salvatore, L., et al. (2020) Atezotribe: A Randomised Phase II Study of FOLFOXIRI Plus Bevacizumab Alone or in Combination with Atezolizumab as Initial Therapy for Patients with Unresectable Metastatic Colorectal Cancer. BMC Cancer, 20, Article No. 683. [Google Scholar] [CrossRef] [PubMed]
[45] Ferrara, N., Gerber, H. and LeCouter, J. (2003) The Biology of VEGF and Its Receptors. Nature Medicine, 9, 669-676. [Google Scholar] [CrossRef] [PubMed]
[46] André, T., Lonardi, S., Wong, K.Y.M., Lenz, H.-J., Gelsomino, F., Aglietta, M., et al. (2022) Nivolumab Plus Low-Dose Ipilimumab in Previously Treated Patients with Microsatellite Instability-High/Mismatch Repair-Deficient Metastatic Colorectal Cancer: 4-Year Follow-Up from Checkmate 142. Annals of Oncology, 33, 1052-1060. [Google Scholar] [CrossRef] [PubMed]
[47] Zheng, Z., Zhao, Y., Xie, J., Gao, M., Wang, Y. and Li, X. (2024) Clinical Risk Factors of Bevacizumab-Related Hypertension in Patients with Metastatic Colorectal Cancer: A Retrospective Study. Frontiers in Pharmacology, 15, Article 1463026. [Google Scholar] [CrossRef] [PubMed]
[48] Vonica, R.C., Butuca, A., Morgovan, C., Pumnea, M., Cipaian, R.C., Frum, A., et al. (2025) Bevacizumab—Insights from Eudravigilance Database on the Assessments of the Safety Profile of Monoclonal Antibodies Used as Targeted Cancer Treatment. Pharmaceuticals, 18, Article 501. [Google Scholar] [CrossRef] [PubMed]
[49] Ribas, A., Lawrence, D., Atkinson, V., Agarwal, S., Miller, W.H., Carlino, M.S., et al. (2019) Combined BRAF and MEK Inhibition with PD-1 Blockade Immunotherapy in Braf-Mutant Melanoma. Nature Medicine, 25, 936-940. [Google Scholar] [CrossRef] [PubMed]
[50] Sullivan, R.J., Hamid, O., Gonzalez, R., Infante, J.R., Patel, M.R., Hodi, F.S., et al. (2019) Atezolizumab plus Cobimetinib and Vemurafenib in BRAF-Mutated Melanoma Patients. Nature Medicine, 25, 929-935. [Google Scholar] [CrossRef] [PubMed]
[51] Dummer, R., Lebbé, C., Atkinson, V., Mandalà, M., Nathan, P.D., Arance, A., et al. (2020) Combined PD-1, BRAF and MEK Inhibition in Advanced Braf-Mutant Melanoma: Safety Run-In and Biomarker Cohorts of Combi-I. Nature Medicine, 26, 1557-1563. [Google Scholar] [CrossRef] [PubMed]
[52] Liu, M., Liu, Q., Hu, K., Dong, Y., Sun, X., Zou, Z., et al. (2024) Colorectal Cancer with BRAF V600E Mutation: Trends in Immune Checkpoint Inhibitor Treatment. Critical Reviews in Oncology/Hematology, 204, Article ID: 104497. [Google Scholar] [CrossRef] [PubMed]
[53] Bertagnolli, M.M., Redston, M., Compton, C.C., Niedzwiecki, D., Mayer, R.J., Goldberg, R.M., et al. (2011) Microsatellite Instability and Loss of Heterozygosity at Chromosomal Location 18q: Prospective Evaluation of Biomarkers for Stages II and III Colon Cancer—A Study of CALGB 9581 and 89803. Journal of Clinical Oncology, 29, 3153-3162. [Google Scholar] [CrossRef] [PubMed]
[54] Ribic, C.M., Sargent, D.J., Moore, M.J., Thibodeau, S.N., French, A.J., Goldberg, R.M., et al. (2003) Tumor Microsatellite-Instability Status as a Predictor of Benefit from Fluorouracil-Based Adjuvant Chemotherapy for Colon Cancer. New England Journal of Medicine, 349, 247-257. [Google Scholar] [CrossRef] [PubMed]
[55] Wang, Z., Wang, X., Zhang, X., Leng, J., Cui, M., Zhang, J., et al. (2025) Toripalimab, Bevacizumab, and Irinotecan in dMMR/MSI Locally Advanced Colorectal Cancer: First-Stage Results from a Phase 1b/2 Trial. Cell Reports Medicine, 6, Article ID: 102296. [Google Scholar] [CrossRef] [PubMed]
[56] 薛静, 黎小妍. 特瑞普利单抗所致不良反应文献分析[J]. 中国临床药学杂志, 2022, 31(5): 375-379.
[57] Burgers, P.M.J. and Kunkel, T.A. (2017) Eukaryotic DNA Replication Fork. Annual Review of Biochemistry, 86, 417-438. [Google Scholar] [CrossRef] [PubMed]
[58] Jin, Y., Huang, R., Guan, W., Wang, Z., Mai, Z., Li, Y., et al. (2024) A Phase II Clinical Trial of Toripalimab in Advanced Solid Tumors with Polymerase Epsilon/polymerase Delta (POLE/POLD1) Mutation. Signal Transduction and Targeted Therapy, 9, Article No. 227. [Google Scholar] [CrossRef] [PubMed]
[59] Chen, H., Wei, J., Tang, Q., Li, G., Zhou, Y. and Zhu, Z. (2025) Beyond Proofreading: POLD1 Mutations as Dynamic Orchestrators of Genomic Instability and Immune Evasion in Cancer. Frontiers in Immunology, 16, Article 1600233. [Google Scholar] [CrossRef] [PubMed]
[60] Tie, J., Cohen, J.D., Lahouel, K., Lo, S.N., Wang, Y., Kosmider, S., et al. (2022) Circulating Tumor DNA Analysis Guiding Adjuvant Therapy in Stage II Colon Cancer. New England Journal of Medicine, 386, 2261-2272. [Google Scholar] [CrossRef] [PubMed]
[61] van Rees, J.M., Wullaert, L., Grüter, A.A.J., Derraze, Y., Tanis, P.J., Verheul, H.M.W., et al. (2023) Circulating Tumour DNA as Biomarker for Rectal Cancer: A Systematic Review and Meta-Analyses. Frontiers in Oncology, 13, Article 1083285. [Google Scholar] [CrossRef] [PubMed]
[62] Nakamura, Y., Watanabe, J., Akazawa, N., Hirata, K., Kataoka, K., Yokota, M., et al. (2024) ctDNA-Based Molecular Residual Disease and Survival in Resectable Colorectal Cancer. Nature Medicine, 30, 3272-3283. [Google Scholar] [CrossRef] [PubMed]
[63] Wullaert, L., Jansen, M.P.H.M., Kraan, J., Meyer, Y.M., Voigt, K., Makrodimitris, S., et al. (2025) Circulating Tumour Cells & Circulating Tumour DNA in Patients with Resectable Colorectal Liver Metastases (MIRACLE): A Prospective, Observational Biomarker Study. eClinicalMedicine, 87, Article ID: 103406. [Google Scholar] [CrossRef] [PubMed]