代谢功能障碍相关脂肪性肝病(MASLD)与 结直肠癌之间的关联：诊断与疾病进展的 全面综述
Association between Metabolic Dysfunction-Related Fatty Liver Disease (MASLD) and Colorectal Cancer: A Comprehensive Review of Diagnosis and Disease Progression
摘要: 本综述探讨了代谢功能障碍相关脂肪性肝病(MASLD)与结直肠癌(CRC)之间的关联，重点关注其对疾病诊断、病程进展及潜在机制的影响。方法：通过对流行病学数据、病理生理机制及临床研究进行全面综合分析，旨在深入探究MASLD与CRC之间的关联性。结果：越来越多的证据表明，MASLD与结直肠腺瘤及结直肠癌的发病风险显著增加密切相关。这种风险在伴有晚期肝纤维化或严重代谢功能障碍的个体中尤为突出。促进这一关联的关键机制因素包括慢性炎症、胰岛素抵抗、肠–肝轴紊乱以及脂肪因子失衡，这些因素共同构成了利于肿瘤发生的微环境。从临床角度看，MASLD可能会影响CRC确诊时的分期、患者对治疗的耐受性以及总体生存结局；然而，目前仍缺乏高质量的干预性研究来进一步证实这些观察结果。结论：MASLD (尤其是其进展期形式)是结直肠肿瘤发生的显著临床风险因素。这一证据强调了对MASLD高危人群加强结直肠癌监测的必要性，必须实施更精准的筛查方案和全面的代谢管理措施。未来的研究应重点开展干预性试验，并构建跨器官系统的预测模型，旨在将已明确的关联性转化为更优的预防和治疗成果。
Abstract: This review discusses the relationship between metabolic dysfunction-related fatty liver disease (MASLD) and colorectal cancer (CRC), focusing on its impact on disease diagnosis, disease progression and potential mechanism. Methods: Through the comprehensive analysis of epidemiological data, pathophysiological mechanism and clinical research, the purpose is to deeply explore the correlation between MASLD and CRC. Results: More and more evidence show that MASLD is closely related to the significantly increased risk of colorectal adenoma and colorectal cancer. This risk is particularly prominent in individuals with advanced liver fibrosis or severe metabolic dysfunction. The key mechanism factors that promote this association include chronic inflammation, insulin resistance, intestinal-hepatic axis disorder and fat factor imbalance, which together constitute the microenvironment conducive to tumor occurrence. From the clinical point of view, MASLD may affect the stage of CRC diagnosis, the patient’s tolerance to treatment and the overall survival outcome. However, there is still a lack of high-quality intervention studies to further confirm these observations. Conclusion: MASLD (especially its advanced form) is a significant clinical risk factor for colorectal cancer. This evidence emphasizes the necessity of strengthening the monitoring of colorectal cancer in high-risk population of MASLD, and more accurate screening scheme and comprehensive metabolic management measures must be implemented. In the future, we should focus on intervention experiments and build a prediction model of cross-organ system, aiming at transforming the clear correlation into better prevention and treatment results.
文章引用：李志君, 朱鹏. 代谢功能障碍相关脂肪性肝病(MASLD)与 结直肠癌之间的关联：诊断与疾病进展的 全面综述[J]. 临床医学进展, 2026, 16(2): 1402-1413. https://doi.org/10.12677/acm.2026.162527

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