以分子检测为基础的肿瘤分子分型及个体化治疗方案使当代的结直肠癌治疗逐步走向"同病异治"模式,结直肠癌同病异治两个最常见的应用,一是RAS基因突变与分子靶向药物的应用,二是微卫星不稳定(MSI)状态与林奇综合征的诊断和治疗。其中RAS基因野生型患者使用西妥昔单抗联合化疗方案获益显著,而林奇综合征的患者与微卫星稳定患者相比,显示了更好的预后,且其不能从化疗药物氟尿嘧啶中获益。然而,为了让更多的结肠癌患者获益,我们还需要继续探寻对结肠癌更有效更全面的分子分型标准。
Based on the modern molecular detection, molecular classification of tumors and individualized treatment plan successfully makes the patient with the same disease treated with various methods. And the most widely used are the RAS gene mutations with the molecular targeted drugs applied and MSI status with lynch syndrome diagnoed and treatment. However, the benefit of cetuximab was limited to patients with RAS wild-type tumors, and patients of lynch syndrome have a better prognosis but no benefits from fluorouracil(FU)-based adjuvant therapy compared with patients who have microsatellite-stable tumors. Then we are led to explore more effectively and comprehensive molecular classification standards to benefit more patients with colorectal cancer.