结直肠癌的共识分子分型及其临床应用展望OA北大核心CSTPCD
Consensus molecular subtype of colorectal cancer and its clinical application prospects
结直肠癌(CRC)具有高度异质性.传统TNM分期不能很好地区分CRC异质性,已不能满足治疗需求.整合患者临床特征、癌组织分子遗传学变化、转录组和蛋白质组变化以及免疫基质等特征,共识分子分型(CMS)是迄今为止对CRC异质性的最佳描述.本文从三类CRC癌组织分子遗传学改变(染色体不稳定、微卫星不稳定和CpG岛甲基化表型)出发,系统阐述不同CMS分型CRC患者的临床特点、治疗方向和预后评估以及与免疫治疗和肠道微生物群组改变的联系.随着测序技术和前瞻性精准医学临床试验的持续探索,以CMS分型为基础的"多分子-多药物"治疗模式必将成为未来精准医学与个体化医疗的核心.
Colorectal cancer(CRC)is highly heterogeneous,but traditional TNM staging cannot distinguish the heterogeneity of CRC well,which can no longer meet the treatment needs.Integrating the clinical features,molecular genetic changes in cancer tissue,transcriptome and proteome changes,as well as immune matrix characteristics,the consensus molecular subtype(CMS)of CRC is by far the best description of its heterogeneity.This paper first discusses the molecular genetic changes of three types of CRC cancer tissues(chromosomal instability,microsatellite instability,and CpG island methylation phenotype).Then it systematically elaborates on the clinical characteristics,treatment directions,and prognosis evaluation of CRC patients with different CMS subtypes,as well as their relationship with immunotherapy and changes in gut microbiota.With the continuous improvement of sequencing technology and the prospective precision medicine clinical trial exploration,the"multi-molecule multi-drug"treatment model based on CMS typing will become the core of future precision medicine and personalized medicine.
靳天乐;刘雨泉;王润石;侯妮;李杰
西安交通大学第二附属医院普通外科,陕西西安 710004||西安交通大学宗濂书院,陕西西安 710061西安交通大学宗濂书院,陕西西安 710061||西安交通大学医学部基础医学院细胞生物学与遗传学系,陕西西安 710061西安交通大学宗濂书院,陕西西安 710061西安交通大学医学部基础医学院细胞生物学与遗传学系,陕西西安 710061西安交通大学第二附属医院普通外科,陕西西安 710004
临床医学
结直肠癌(CRC)异质性共识分子分型(CMS)临床应用
colorectal cancer(CRC)heterogeneityconsensus molecular subtype(CMS)clinical application
《西安交通大学学报(医学版)》 2024 (004)
525-534 / 10
陕西省重点研发计划国际科技合作计划项目(No.2021KW-59);西安交通大学医学部基础-临床融合创新项目(No.YXJLRH2022083)Supported by the Key Research and Development Plan of Shaanxi Province(No.2021KW-59)and Xi'an Jiaotong University Health Science Center Basic-Clinical Fusion Innovation Project(No.YXJLRH2022083)
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