结直肠癌腹膜转移的研究进展

Advance of peritoneal metastasis of colorectal cancer

腹膜转移是结直肠癌常见的远处转移,其预后较差。最初结直肠癌腹膜转移被认为是疾病的终末期。近年来学者对其转移机制进行了不断的探索,目前较为认可的转移机制理论是“种子——土壤”学说。结直肠癌腹膜转移早期无特异性临床症状,确诊时往往已经是晚期。影像学检查是常用的诊断手段,探查性腹腔镜检查是确诊腹膜转移的“金标准”,并可指导后续的治疗。目前针对腹膜转移的患者主要采取肿瘤细胞减灭术联合腹腔内热灌注治疗以及腹腔加压气溶胶化疗等。通过合适的治疗,患者的预后能够得到改善。本文就结直肠癌腹膜转移的机制、临床表现、诊断及治疗策略进行阐述,并探讨当前面临的挑战,从而加深临床医师对结直肠癌腹膜转移的认识。

Peritoneal metastasis is a common distant metastasis of colorectal cancer and it is associated with poor prognosis.While previously peritoneal metastasis of colorectal cancer is considered a terminal stage of the disease.Recent years research in⁃to the mechanism of metastasis have seen ongoing.The prevailing theory is the"seed-soil"theory,which elucidates the underly⁃ing mechanisms.Diagnosis of peritoneal metastasis of colorectal cancer is often made in the advanced stage due to nonspecific early symptoms.Imaging examinations are commonly used for diagnosis,while exploratory laparoscopy serves as the gold standard for confirmation and treatment guidance.Current treatment options for peritoneal metastasis include cytoreductive surgery com⁃bined with hyperthermic intraperitoneal chemotherapy,and pressurized intraperitoneal aerosol chemotherapy.Proper treatment can improve patient prognosis.This article explores the mechanisms,clinical manifestations,diagnosis,and treatment strategies for peri⁃toneal metastasis of colorectal cancer,as well as the current challenges in this field,in order to enhance Clinicians’understand⁃ing of peritoneal metastasis in colorectal cancer.