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中华结直肠疾病电子杂志 ›› 2025, Vol. 14 ›› Issue (02) : 97 -113. doi: 10.3877/cma.j.issn.2095-3224.2025.02.001

指南与共识

中国恶性肿瘤整合诊治指南-结肠癌(2024版)
中国抗癌协会, 中国抗癌协会大肠癌专业委员会   
  • 收稿日期:2024-10-18 出版日期:2025-04-25

CACA guidelines for holistic integrative management of colon cancer (2024 Edition)

Anti-Cancer Association China, Committee of Colorectal Cancer CACA the   

  • Received:2024-10-18 Published:2025-04-25
引用本文:

中国抗癌协会, 中国抗癌协会大肠癌专业委员会. 中国恶性肿瘤整合诊治指南-结肠癌(2024版)[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(02): 97-113.

Anti-Cancer Association China, Committee of Colorectal Cancer CACA the. CACA guidelines for holistic integrative management of colon cancer (2024 Edition)[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(02): 97-113.

《中国恶性肿瘤整合诊治指南-结肠癌(2024版)》充分参考了国内外最新研究成果,广泛整合了相关领域专家意见,形成了更新版本。流行病学部分,根据国家癌症中心最新研究数据,更新了结直肠癌的发病率、死亡率等详细数据。筛查部分,将一般人群筛查起始年龄改为45岁。诊断部分,将外周血MSI检测作为病理取材受限患者的可选择方案之一。外科部分,建议有经验的中心常规开展CME手术;对经自然腔道取标本手术的安全性进行补充说明。内科部分,增加了免疫治疗的循证医学证据,推荐dMMR/MSI-H的患者可考虑将免疫治疗作为治疗方案;描述了ctDNA在术后辅助治疗决策中的作用;推荐免疫治疗作为对MSI-H肝转移患者的治疗方案之一;纳武利尤单抗联合伊匹木单抗的双免疗法作为姑息治疗的可选择方案之一。中医药部分,将“辨证施治原则”调整为“辨病论治与辨证施治相结合的原则”,增加了结肠癌防变治疗期辨证施治内容,并增加了中医非药物疗法的应用。

CACA guidelines for holistic integrative management of colon cancer (2024 Edition)has been updated with full reference to the latest research results at home and abroad,and the opinions of experts in related fields have been widely integrated. In the epidemiology section,the incidence and mortality rates of colorectal cancer have been updated according to the latest research data from the National Cancer Center. In the screening section,the starting age of screening for the general population has been changed to 45 years old. In the diagnosis section,peripheral blood MSI testing is included as one of the available options for patients with limited pathologic access. In the surgery section,it is recommended that experienced centers routinely perform CME procedures; additional clarification is provided on the safety of the procedure of taking specimens through the natural cavity. In the internal medicine section,evidence-based medical evidence for immunotherapy was added,recommending that immunotherapy be considered as a treatment option for patients with dMMR/MSI-H; the role of ctDNA in postoperative adjuvant therapy decision-making was described; immunotherapy was recommended as one of the therapeutic options for patients with liver metastases from MSI-H; and double-immunotherapy with nabulizumab in combination with ipilimumab was recommended as one of the available options for palliative care. In the section on traditional Chinese medicine,the “principle of evidence-based treatment” is adjusted to “principle of combining disease diagnosis and treatment with evidence-based treatment”,and the content of evidence-based treatment during the prevention and treatment of colon cancer is added,as well as the application of non-pharmacological therapies in traditional Chinese medicine.

图1 结肠癌的诊断流程。注*PET-CT不作为常规推荐
表1 AJCC 第八版结直肠癌分期系统对应表
图2 非转移性结肠癌的处理流程
表2 复发风险评分(CRS)
图3 同时性转移性结肠癌处理流程
图4 异时性转移性结肠癌处理流程
图5 术后CEA持续升高的处理流程
《中国恶性肿瘤整合诊治指南-结肠癌(2024版)》编委会成员名单
名誉主编
樊代明 空军军医大学西京消化病医院
主编
王锡山 中国医学科学院肿瘤医院
副主编
顾 晋 北京大学肿瘤医院
丁克峰 浙江大学医学院附属第二医院
房学东 吉林大学中日联谊医院
沈 琳 北京大学肿瘤医院
徐忠法 山东第一医科大学第三附属医院
许剑民 复旦大学附属中山医院
王贵玉 哈尔滨医科大学附属第二医院
王贵英 河北医科大学第二医院
顾艳宏 江苏省人民医院
金 晶 中国医学科学院肿瘤医院深圳医院
梁 洁 空军军医大学西京医院
王 泠 北京大学人民医院
编委(姓氏笔划排序)
丁克峰 浙江大学医学院附属第二医院
王小强 陕西省人民医院
王自强 四川大学华西医院
王贵玉 哈尔滨医科大学附属第二医院
王贵英 河北医科大学第二医院
王 泠 北京大学人民医院
王莎莎 青岛大学附属医院
王 猛 浙江省肿瘤医院
王锡山 中国医学科学院肿瘤医院
孔大陆 天津医科大学肿瘤医院
巴 一 天津医科大学肿瘤医院
冯 波 上海交通大学医学院附属瑞金医院
方庆霄 天津医科大学肿瘤医院
匡 毅 重庆大学附属肿瘤医院
朱玉萍 浙江省肿瘤医院
朱 骥 浙江省肿瘤医院
任 黎 复旦大学附属中山医院
庄成乐 同济大学附属第十人民医院
庄 競 河南省肿瘤医院
关 旭 中国医学科学院肿瘤医院
刘 正 中国医学科学院肿瘤医院
刘洪洲 长治医学院附属和平医院
刘海义 山西省肿瘤医院
刘 骞 中国医学科学院肿瘤医院
江 波 山西省肿瘤医院
江晓晖 南通市肿瘤医院
汤庆超 哈尔滨医科大学附属第二医院
许剑民 复旦大学附属中山医院
孙凌宇 哈尔滨医科大学附属第四医院
李 军 浙江大学医学院附属第二医院
李 明 北京大学肿瘤医院
李 健 北京大学肿瘤医院
李 涛 新疆维吾尔自治区人民医院
李德川 浙江省肿瘤医院
杨 宇 哈尔滨医科大学附属第二医院
杨 超 大连医科大学附属第一医院
杨 斌 中山大学孙逸仙纪念医院
杨熊飞 甘肃省人民医院
吴小剑 中山大学附属第六医院
邱 萌 四川大学华西医院
何国栋 复旦大学附属中山医院
邹霜梅 中国医学科学院肿瘤医院
应杰儿 浙江省肿瘤医院
汪 欣 北京大学第一医院
沈 琳 北京大学肿瘤医院
宋 纯 上海市东方医院
张红梅 中国医学科学院肿瘤医院
张苏展 浙江大学医学院附属第二医院
张寿儒 重庆大学附属肿瘤医院
张 昭 天津市人民医院
张 俊 上海交通大学医学院附属瑞金医院
张 森 广西医科大学第一附属医院
张巍远 哈尔滨医科大学附属第二医院
陈小兵 河南省肿瘤医院(中国医学科学院肿瘤医院河南医院)
陈 功 中山大学肿瘤防治中心
陈瑛罡 中国医学科学院肿瘤医院深圳医院
武爱文 北京大学肿瘤医院
易 波 江西省肿瘤医院
金 晶 中国医学科学院肿瘤医院深圳医院
房学东 吉林大学中日联谊医院
孟庆凯 辽宁省肿瘤医院
赵 任 上海交通大学医学院附属瑞金医院
赵青川 空军军医大学西京医院
赵紫罡 成都市第六人民医院
俞少俊 浙江大学医学院附属第二医院
钟芸诗 复旦大学附属中山医院
钟 鸣 上海交通大学医学院附属仁济医院
姜 争 中国医学科学院肿瘤医院
姚庆华 浙江中医药大学附属第二医院
袁维堂 郑州大学第一附属医院
袁 瑛 浙江大学医学院附属第二医院
夏立建 山东第一医科大学
顾艳宏 江苏省人民医院
顾 晋 北京大学肿瘤医院
徐阿曼 安徽医科大学第一附属医院
徐忠法 山东第一医科大学第三附属医院
徐瑞华 中山大学肿瘤防治中心
唐 源 中国医学科学院肿瘤医院
梁 洁 空军军医大学西京医院
韩方海 广东省第二人民医院
韩 宇 哈尔滨医科大学附属肿瘤医院
鲁守堂 山东第一医科大学第三附属医院
蔡三军 复旦大学附属肿瘤医院
燕 锦 四川省肿瘤医院
戴 勇 山东大学齐鲁医院
鞠海星 浙江省肿瘤医院
校稿
樊代明 王锡山 王贵玉 吕靖芳 刘恩瑞 杨 明
张 麟 郑朝旭 赵志勋 陶金华 黄海洋 高凡贺
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