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中华结直肠疾病电子杂志 ›› 2025, Vol. 14 ›› Issue (03) : 193 -201. doi: 10.3877/cma.j.issn.2095-3224.2025.03.001

指南与共识

结直肠癌腹膜转移诊治专家共识(2025版)
中国医师协会结直肠肿瘤专业委员会   
  • 收稿日期:2025-05-27 出版日期:2025-06-25
  • 基金资助:
    国家临床重点建设专科(武汉大学中南医院普外科)专项基金国家疑难病症诊治能力提升工程建设项目(武汉大学中南医院肿瘤方向)专项基金

Expert consensus on the diagnosis and treatment of colorectal cancer peritoneal metastasis (2025 edition)

Cancer Professional Committee of the Chinese Medical Doctor Association Colorectal   

  • Received:2025-05-27 Published:2025-06-25
引用本文:

中国医师协会结直肠肿瘤专业委员会. 结直肠癌腹膜转移诊治专家共识(2025版)[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(03): 193-201.

Cancer Professional Committee of the Chinese Medical Doctor Association Colorectal. Expert consensus on the diagnosis and treatment of colorectal cancer peritoneal metastasis (2025 edition)[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(03): 193-201.

结直肠癌是我国最常见的恶性肿瘤之一,发病率和死亡率分别位居全部恶性肿瘤的第二位和第四位。转移和复发是导致患者死亡的主要原因,其中,腹膜是结直肠癌常见的转移部位,仅次于肝转移和肺转移,但其预后却远差于肝转移和肺转移。结直肠癌腹膜转移具有早期诊断困难、症状重、预后差的特点,其规范化诊治对改善患者的预后和提高生活质量至关重要。中国医师协会结直肠肿瘤专业委员会早在2017年就组织国内结直肠癌领域权威专家编写了《结直肠癌腹膜转移诊治中国专家意见(2017版)》,并于2022年进行了修改。鉴于结直肠癌腹膜转移的研究进展,中国医师协会结直肠肿瘤专业委员会组织国内多学科专家在《结直肠癌腹膜转移诊治中国专家意见(2017版)》和2022年修改的基础上,基于最新研究结果和循证医学证据,经过反复讨论,再次进行了修改更新,编写了《结直肠癌腹膜转移诊治专家共识(2025版)》,对结直肠癌腹膜转移的定义、诊断、治疗及预防等方面达成初步共识,以期指导和规范结直肠癌腹膜转移的诊断和治疗,制定合理有效的综合治疗方案,延长结直肠癌腹膜转移患者生存时间并改善生活质量,从而提高我国结直肠癌的整体诊治水平。

Colorectal cancer is one of the most common malignant tumors in China, ranking second in morbidity and fourth in mortality. Metastasis and recurrence are the leading causes of patient death, and the peritoneum is a frequent site of metastasis in colorectal cancer, second only to liver and lung metastases. However, the prognosis of peritoneal metastasis is much worse than hepatic and pulmonary metastasis. Colorectal cancer peritoneal metastasis is characterized by difficult early diagnosis, severe symptoms and poor prognosis. Its standardized diagnosis and treatment are crucial for improving the prognosis of patients and enhancing their quality of life. The Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association organized authoritative experts in the field of colorectal cancer in China to compile the “Chinese Expert Consensus on the Diagnosis and Treatment of Colorectal Cancer Peritoneal Metastasis (2017 Edition)” as early as 2017, and revised it in 2022. In view of the research progress of colorectal cancer peritoneal metastasis, the Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association organized domestic multidisciplinary experts to revise and update the “Chinese Expert Consensus on the Diagnosis and Treatment of Colorectal Cancer Peritoneal Metastasis (2017 Edition)” and the 2022 revision based on the latest research results and evidence-based medical evidence after repeated discussions. The “Expert Consensus on the Diagnosis and Treatment of Peritoneal Metastasis of Colorectal Cancer (2025 Edition)” was compiled, reaching a preliminary consensus on the definition, diagnosis,treatment and prevention of colorectal cancer peritoneal metastasis, with the aim of guiding and standardizing the diagnosis and treatment of colorectal cancer peritoneal metastasis, developing reasonable and effective comprehensive treatment plans, prolonging survival time and improving quality of life for colorectal cancer peritoneal metastasis patients, thereby raising the overall level of diagnosis and treatment for colorectal cancer in China.

表1 推荐分级的评估、制定与评价证据质量描述[8]
图1 腹膜癌指数(PCI)分期系统[25] 注:LS为病灶大小评分
表2 腹膜表面疾病严重程度评分(PSDSS)标准[26]
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