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结肠镜检查和息肉切除术后监测指南的最新内容及相关研究进展

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中华胃肠外科杂志 2024年第1期27卷 99-104页

作者：朱云峰朱应双刘成成胡烨婷丁克峰海宁市中医院、海宁市肿瘤防治研究所海宁314400 浙江大学医学院附属第二医院大肠外科、恶性肿瘤预警与干预教育部重点实验室、浙江省医学分子生物学重点实验室、浙江省恶性肿瘤临床医学研究中心杭州310009 消化系统医药基础研究创新中心(教育部) 杭州310058

随着结直肠癌筛查的不断普及,筛查后人群的监测管理也成为结直肠癌防控的关键环节之一。近年来,针对筛查后人群的结直肠癌发病和死亡风险的研究证据不断涌现,同时,欧美国家的相关行业协会基于最新的研究证据,陆续更新了结肠镜检查和息... 详细信息

随着结直肠癌筛查的不断普及,筛查后人群的监测管理也成为结直肠癌防控的关键环节之一。近年来,针对筛查后人群的结直肠癌发病和死亡风险的研究证据不断涌现,同时,欧美国家的相关行业协会基于最新的研究证据,陆续更新了结肠镜检查和息肉切除术后的结肠镜监测指南。本文全面总结了目前关于结直肠癌筛查后人群的结直肠癌风险相关研究进展以及相关指南更新要点,以期为指导我国相关研究的开展以及监测指南或共识的制定提供参考。

关键词：结直肠癌筛查腺瘤锯齿状息肉结肠镜监测

早发性结直肠癌的流行病学特征分析:基于单中心前瞻性队列研究

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中华胃肠外科杂志 2024年第5期27卷 457-463页

作者：金天朱应双刘成成徐行陆玮肖乾丁克峰郑树浙江大学医学院附属第二医院大肠外科、恶性肿瘤预警与干预教育部重点实验室、浙江省恶性肿瘤临床医学研究中心杭州310009 浙江大学医学院附属第二医院护理部杭州310009 消化系统医药基础研究创新中心(教育部) 杭州310058

目的探究我国早发性结直肠癌(EOCRC)和晚发性结直肠癌(LOCRC)患者中流行病学特征和暴露因素的分布差异,为早发性结直肠癌的预防及临床诊疗提供参考与指导。方法依托于结直肠癌专病队列纳入了2018年6月至2023年2月期间在浙江大学医学院... 详细信息

目的探究我国早发性结直肠癌(EOCRC)和晚发性结直肠癌(LOCRC)患者中流行病学特征和暴露因素的分布差异,为早发性结直肠癌的预防及临床诊疗提供参考与指导。方法依托于结直肠癌专病队列纳入了2018年6月至2023年2月期间在浙江大学医学院附属第二医院大肠外科首次确诊为原发性结直肠癌的5377例患者,对患者进行基本信息和流行病学信息的问卷调查。并以50岁为年龄分界值进行分组,将年龄≥50岁者定义为LOCRC,年龄0.05)。结论我国的EOCRC与LOCRC患者在不良生活方式以及饮食等流行病学特征方面存在差异。

关键词：结直肠肿瘤,早发性流行病学特征饮食习惯生活方式

A predictive model for early recurrence of colorectal-cancer liver metastases based on clinical parameters

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Gastroenterology Report 2021年第3期9卷 241-251,I0002页

作者： Siqi Dai Yao Ye Xiangxing Kong Jun Li kefeng ding Department of Colorectal Surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangP.R.China Cancer Institute(Key Laboratory of Cancer Prevention and Intervention China National Ministry of EducationKey Laboratory of Molecular Biology in Medical SciencesZhejiang ProvinceChina)The Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangP.R.China

Background:The prognosis for patients with colorectal-cancer liver metastases(CRLM)after curative surgery remains poor and shows great *** recurrence,defined as tumor recurrence within 6 months of curative surgery,is associated with poor survival,requiring earlier detection and *** study aimed to develop and validate a bedside model based on clinical parameters to predict early recurrence in CRLM patients and provide insight into post-operative surveillance *** and methods:A total of 202 consecutive CRLM patients undergoing curative surgeries between 2012 and 2019 were retrospectively enrolled and randomly assigned to the training(n=150)and validation(n=52)*** information and radiological,pathological,and laboratory findings were extracted from medical *** factors for early recurrence were identified via a multivariate logistic-regression model to develop a predictive nomogram,which was validated for discrimination,calibration,and clinical ***:Liver-metastases number,lymph-node suspicion,neurovascular invasion,colon/rectum location,albumin and post-operative carcinoembryonic antigen,and carbohydrate antigen 19–9 levels(CA19–9)were independent predictive factors and were used to construct the nomogramfor early recurrence after curative *** area under the curve was 0.866 and 0.792 for internal and external validation,*** model significantly outperformed the clinical risk score and Beppu’s model in our data *** the lift curve,the nomogram boosted the detection rate in post-operative surveillance by two-fold in the top 30%high-risk ***:Our model for early recurrence in CRLM patients after curative surgeries showed superior performance and could aid in the decision-making for selective follow-up strategies.

关键词： colorectal cancer liver metastases early recurrence prediction model post-operative surveillance

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局部进展期直肠癌的手术时机把握

外科理论与实践 2024年第3期29卷 206-210页

作者：谢海艇胡烨婷李军丁克峰浙江大学医学院附属第二医院大肠外科恶性肿瘤预警与干预教育部重点实验室浙江杭州310009 消化系统医药基础研究创新中心(教育部) 浙江杭州310058 浙江省恶性肿瘤临床医学研究中心浙江杭州310058

局部进展期直肠癌(LARC)术后具有较高的局部复发率和远处转移率,仅靠手术难以达到有效治疗。新辅助放化疗联合根治性手术是其标准治疗,可明显降低LARC的局部复发率,但却显著危害病人肛门和泌尿生殖功能,严重影响生活质量。因此如何避免... 详细信息

局部进展期直肠癌(LARC)术后具有较高的局部复发率和远处转移率,仅靠手术难以达到有效治疗。新辅助放化疗联合根治性手术是其标准治疗,可明显降低LARC的局部复发率,但却显著危害病人肛门和泌尿生殖功能,严重影响生活质量。因此如何避免目前“一刀切”的治疗模式,选择最佳的根治性手术时机,使其兼顾肿瘤学预后和生活质量是目前的研究热点和难点。笔者认为通过术前评估LARC风险,合理选择根治性手术时机是目前行之有效的策略:对术前风险评估为中低危的病人可考虑直接手术,或术前化疗联合根治性手术;对于高危病人,可通过加强术前新辅助治疗等策略,延后根治性手术时机,以改善肿瘤学预后。本文围绕LARC根治性的时机选择进行分析讨论,为后续LARC开展个体化和精细化的治疗选择提供思路。

关键词：局部进展期直肠癌根治性手术手术时机新辅助放化疗

Efficacy of rigosertib, a small molecular RAS signaling disrupter for the treatment of KRAS-mutant colorectal cancer

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Cancer Biology & Medicine 2022年第2期19卷 213-228页

作者： Xinyi Zhou Qian Xiao Dongliang Fu Haochen Zhang Yang Tang Jinjie He Yeting Hu Xiangxing Kong Fei Teng Xiangrui Liu Ying Yuan kefeng ding Department of Colorectal Surgery and Oncology Key Laboratory of Cancer Prevention and InterventionMinistry of Educationthe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China Department of Medical Oncology Key Laboratory of Cancer Prevention and InterventionMinistry of Educationthe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China Hangzhou Oncocare Co Ltd Hangzhou 310009China Department of Pharmacology Zhejiang University School of MedicineHangzhou 310058China Cancer Center Zhejiang UniversityHangzhou 310009China

Objective:Mutant KRAS,the principal isoform of RAS,plays a pivotal role in the oncogenesis of colorectal cancer by constitutively activating the RAF/MEK/ERK and PI3K/AKT *** targeted therapies are urgently *** investigated whether rigosertib,a benzyl styryl sulfone RAS signaling disruptor,could selectively kill KRAS-mutant colorectal cancer ***:CCK-8 was used to determine the cell ***-derived tumor and cancer cell xenograft models were used to detect the inhibitory efficacy of *** cytometry was used to evaluate the apoptosis and cell cycle *** and cell cycle arrest markers were detected by Western ***-DA was used to determine the reactive oxygen *** staining and Western blot were performed to characterize RAS signaling markers in colorectal cancer tissues and ***:Rigosertib(RGS)exhibited a cytotoxic effect against colorectal cancer cells,which was greater in KRAS-mutant ***,RGS induced mitotic arrest and oxidative stress-dependent apoptosis in KRAS-mutant DLD1 and HCT116 ***,RGS disrupted RAS signaling,and the inhibition of RAS/MEK/ERK was independent of cellular oxidative *** patient-derived xenograft models,the response and tumor inhibition of RGS were significantly higher in the KRAS-mutant subgroup,while p-MEK,p-ERK,and p-AKT levels of RGS-treated tumors were significantly ***,in a KRAS-mutant,chemotherapy-resistant patient-derived xenograft model,RGS showed a stronger therapeutic effect than the combination standard therapy involving fluoropyrimidine+oxaliplatin/irinotecan+***:These data showed that targeting RAS signaling using RGS could be a therapeutic treatment for KRAS-mutant colorectal cancer patients.

关键词： Colorectal cancer KRAS mutation rigosertib therapeutic effect RAS signaling

Targeting RAS mutants in malignancies:successes,failures,and reasons for hope

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Cancer Communications 2023年第1期43卷 42-74页

作者： Hang Yang Xinyi Zhou Dongliang Fu Chenqin Le Jiafeng Wang Quan Zhou Xiangrui Liu Ying Yuan kefeng ding Qian Xiao Department of Colorectal Surgery and Oncology Key Laboratory of Cancer Prevention and InterventionMinistry of EducationThe Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310009P.R.China Department of Pharmacology and Department of Gastroenterology of the Second Affiliated Hospital Zhejiang University School of MedicineHangzhouZhejiang 310058P.R.China Department of Cell Biology School of Basic Medical SciencesZhejiang UniversityHangzhouZhejiang 310058P.R.China Cancer Center Zhejiang UniversityHangzhouZhejiang 310058P.R.China Department of Medical Oncology the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiang 310058P.R.China

RAS genes are the most frequently mutated oncogenes and play critical roles in the development and progression of *** mutation,isoform(KRAS,HRAS,and NRAS),position,and type of substitution vary depending on the tissue *** decades of developing RAS-targeted therapies,only small subsets of these inhibitors are clinically effective,such as the allelespecific inhibitors against *** the remaining RAS mutants would require further experimental elucidation ofRAS signal transduction,RASaltered metabolism,and the associated immune *** study reviews the mechanisms and efficacy of novel targeted therapies for different RAS mutants,including KRAS allele-specific inhibitors,combination therapies,immunotherapies,and metabolism-associated therapies.

关键词： RAS mutation Signal transduction RAS-targeted therapy Combination therapy Immunotherapy Cancer metabolism

高等医学院校本科生临床肿瘤学知识结构分析及授课兴趣调查报告——以浙江大学为例

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中国高等医学教育 2024年第5期 25-27,30页

作者：孔祥兴胡烨婷肖乾邓群张琳范让丁克峰浙江大学医学院附属第二医院浙江大学癌症研究院浙江杭州310000

临床肿瘤学是肿瘤学临床实践及科学研究的桥梁,是高等医学院校为培养肿瘤学领域研究人员(如“强基计划”本科生)的教学重点。本研究以浙江大学为例,对高等医学院校本科生临床肿瘤学背景知识结构进行分析,并对其授课兴趣点进行调研,有望... 详细信息

临床肿瘤学是肿瘤学临床实践及科学研究的桥梁,是高等医学院校为培养肿瘤学领域研究人员(如“强基计划”本科生)的教学重点。本研究以浙江大学为例,对高等医学院校本科生临床肿瘤学背景知识结构进行分析,并对其授课兴趣点进行调研,有望为将来肿瘤学相关本科生课程的教学设计提供重要的基础和参考。

关键词：本科生临床肿瘤学知识结构

Postoperative chemotherapy use and survival in non-high-risk young and high-risk old-aged patients with stageⅡcolon cancer

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Holistic Integrative Oncology 2023年第1期2卷 61-70页

作者： Tian Jin Yingshuang Zhu Wei Lu Chenqin Le Lijuan Wang Qian Xiao kefeng ding Department of Colorectal Surgery and Oncology(Key Laboratory of Cancer Prevention and Intervention China National Ministry of EducationKey Laboratory of Molecular Biology in Medical SciencesZhejiang ProvinceChina)The Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Zhejiang Provincial Clinical Research Center for CANCER ZhejiangChina Cancer Center of Zhejiang University ZhejiangChina Centre for Global Health Usher InstituteUnversity of EdinburghEdinburghUK

Purpose Intensive postoperative chemotherapy treatment use in early-onset colon cancer and late-onset colon cancer remains to be defined and their effects on prognosis were *** study aims to investigate whether intensive adjuvant chemotherapy for stageⅡcolon cancer would result in matched survival improvement in young patients(ding *** Of 55,366 eligible stageⅡcolon cancer patients,3341 non-HREOCC patients and 11,722 HRLOCC patients were included.37.68%and 16.8%of patients received adjuvant chemotherapy among non-HREOCC and HRLOCC patients,*** non-HREOCC patients,there was no significant association between adjuvant chemotherapy and CSS(HR=1.09,95%CI0.83–1.44).For HRLOCC patients,adjuvant chemotherapy was associated with a better CSS(HR=0.88,95%CI0.79–0.99).Conclusion Our findings suggested that potential overuse of adjuvant chemotherapy among non-high-risk young patients with stageⅡcolon cancer did not lead to survival improvement,and caution should be called when using chemotherapy in these ***,chemotherapy can be used appropriately for high-risk stageⅡcolon cancer patients aged 70 to 85 years.

关键词： StageⅡcolon cancer Early-onset Late-onset Adjuvant chemotherapy Prognosis

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腹腔镜结直肠癌手术的质量控制

中华胃肠外科杂志 2015年第8期18卷 759-762页

作者：何金杰丁克峰浙江大学医学院附属第二医院肿瘤外科杭州310009

全直肠系膜切除术（TME）在直肠癌手术中其标准化地位的确立以及严格的手术质量评估的引入，使直肠癌的手术质量得到大幅度提高，患者术后局部复发率下降，明显提高了生存率。 TME成为手术质量控制和改善治疗结局的典范。鉴于此，近年... 详细信息

全直肠系膜切除术（TME）在直肠癌手术中其标准化地位的确立以及严格的手术质量评估的引入，使直肠癌的手术质量得到大幅度提高，患者术后局部复发率下降，明显提高了生存率。 TME成为手术质量控制和改善治疗结局的典范。鉴于此，近年来有人相继提出完整结肠系膜切除术（CME）和肛提肌外腹会阴联合切除术（ELAPE）作为相应的质量控制手术，初步研究结果显示，同样能改善治疗效果。腹腔镜在结直肠癌手术中的应用越来越普及。腹腔镜TME和CME手术将进一步改善结直肠癌的整体治疗结局。

关键词：结直肠肿瘤全直肠系膜切除术完整结肠系膜切除术肛提肌外腹会阴联合切除术腹腔镜