术后结直肠癌监测的新范式:集成先进的成像和多omics
Dongxue Yu1, Jiandong Tai2,3
1The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Jilin, China.
Frontiers in physiology
|January 21, 2026
概括
早期发现结直肠癌 (CRC) 复发至关重要. 将先进的成像 (放射学) 与循环瘤DNA (ctDNA) 液体活检相结合,为个性化术后监测和治疗提供了一个有希望的方法.
科学领域:
- 在瘤学瘤学.
- 医疗成像医学成像
- 分子诊断学 分子诊断
背景情况:
- 结肠直肠癌 (CRC) 复发会影响到三分之一的切除后患者.
- 传统的标志物 (CEA,CT/MRI) 通常会错过早期的微转移性疾病.
- 需要先进的工具来改善早期检测和个性化管理.
研究的目的:
- 审查放射学和ctDNA在术后CRC管理中的协同潜力.
- 突出将空间成像数据与时间ctDNA信号集成的好处.
- 概述一条通往基于精度的护理标准的道路.
主要方法:
- 对CRC风险分层和响应监测中的放射学现有证据的审查.
- 分析循环瘤DNA (ctDNA) 作为复发的预后标记.
- 综合研究集成先进的成像和液体活检用于早期复发检测.
主要成果:
- 放射学在量化风险方面显示出显著的潜力 (AUC 0.70-0.85).
- ctDNA是第二阶段-第三阶段CRC复发的最强烈的术后预后标志物,提供3-11个月的领先时间.
- DYNAMIC试验显示,ctDNA导向疗法可以安全地减少化疗的使用.
结论:
- 整合放射学和ctDNA可以加速检测寡头转移性复发.
- 这种综合方法促进了个性化监测和精细的治疗监测.
- 克服标准化和临床验证方面的挑战是采用标准护理的关键.
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