实用医学杂志 ›› 2025, Vol. 41 ›› Issue (19): 2961-2966.doi: 10.3969/j.issn.1006-5725.2025.19.001

• 专家共识 •    

基于肿瘤异质性的转移性结直肠癌患者基因检测专家共识(2025版)

  

  • 收稿日期:2025-07-03 出版日期:2025-10-10 发布日期:2025-10-10

Expert consensus on genetic testing for metastatic colorectal cancer patients based on tumor heterogeneity

  • Received:2025-07-03 Online:2025-10-10 Published:2025-10-10

摘要:

结直肠癌是我国最常见的恶性肿瘤之一,化疗、靶向治疗、免疫治疗是转移性结直肠癌患者的主要治疗手段。随着精准医学的发展,基因检测已成为转移性结直肠癌诊疗过程的核心环节。基因检测结果对于治疗方案的制定具有重要的指导价值。然而,结直肠癌存在一定的异质性。在同一患者的体内,肿瘤的原发灶与转移灶之间、治疗前和治疗后的肿瘤组织可能存在基因特征的差异,全面、准确地认识和理解这些差异对提高治疗的疗效至关重要。为此,广东省抗癌协会肿瘤多学科诊疗专委会组织国内多学科专家,经过反复讨论,编写了《基于肿瘤异质性的转移性结直肠癌患者基因检测专家共识(2025版)》,以期使患者的治疗实现最大化获益,提高我国结直肠癌的整体诊治水平。

关键词: 结直肠癌, 异质性, 基因检测, 专家共识

Abstract:

Colorectal cancer is one of the most prevalent malignant tumors in China. Chemotherapy, targeted therapy, and immunotherapy constitute the primary treatment modalities for patients with metastatic colorectal cancer. With the advancement of precision medicine, next-generation gene sequencing has become an essential component of the diagnostic and therapeutic process for metastatic colorectal cancer. Gene sequencing results provide critical guidance for the formulation of individualized treatment strategies. However, colorectal cancer exhibits significant tumor heterogeneity. Within the same patient, genetic profiles may differ between primary and metastatic tumors, as well as between tumor tissues obtained before and after treatment. A comprehensive and accurate understanding of these genetic differences is crucial for optimizing treatment efficacy. To address this issue, the Multidisciplinary Diagnosis and Treatment Committee of the Guangdong Anti-Cancer Association convened a panel of domestic multidisciplinary experts to develop the Expert Consensus on Genetic Testing for Patients with Metastatic Colorectal Cancer Based on Tumor Heterogeneity (2025 Edition) following extensive discussions. This consensus aims to maximize patient treatment outcomes and enhance the overall standard of colorectal cancer diagnosis and management in China.

Key words: colorectal cancer, heterogeneity, gene sequencing, expert consensus

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