Colorectal cancer is the second most common malignant tumor in China, and its incidence and mortality rates are on the rise, posing a serious threat to the lives and health of the people. Immunotherapy has brought new breakthroughs in colorectal cancer treatment. However, it is effective only for specific molecular subtypes, controversies persist in multiple aspects. Controversies exist in aspects such as molecular testing, imaging evaluation, selection of advantageous populations, and treatment strategies, which have caused troubles for clinicians in making diagnostic and therapeutic decisions. To standardize and guide the clinical practice of colorectal cancer immunotherapy, the Immunology Group of Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association organized multidisciplinary experts to develop this consensus. Based on the disease characteristics of colorectal cancer in the Chinese population and China’s existing diagnostic and treatment systems, the consensus recommendations are grounded in evidence-based medical research. The consensus focuses on imaging evaluation, perioperative treatment, treatment of metastatic colorectal cancer(mCRC), and future directions, while formulating targeted and practical recommendations. The consensus aims to optimize clinical practice, improve disease control, enhance patient quality of life, and prolong survival.

Colorectal cancer has exhibited a persistently rising incidence and mortality rate in China, emerging as a critical public health challenge. For patients with locally advanced rectal cancer, neoadjuvant radiotherapy remains the standard treatment recommended by domestic and international guidelines. Intraoperative radiation therapy (IORT), an modality integrating radiotherapy with surgical intervention, has gained prominence in recent years due to its precision in target localization, enhanced local control efficacy, and reduced risk of perioperative tissue damage. However, unresolved issues persist regarding standardized indications, technical implementation protocols, efficacy evaluation systems, and long-term outcome validation, necessitating evidence-based consensus and multicenter clinical research. To address these challenges,‌ Intraoperative Radiotherapy Working Group, Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association convened multidisciplinary experts. Synthesizing global evidence and clinical experience, the group formulated the expert consensus on intraoperative radiation therapy for colorectal cancer (2025 Edition). This consensus aims to serve as a reference for clinical practice and to advance standardized diagnostic and therapeutic protocols, fostering high-quality development in this field.

In China, colorectal cancer ranks second in incidence and fourth in mortality among all malignant tumors. The incidence of ovarian metastasis in female colorectal cancer patients is increasing. Characterized by insidious symptoms, rapid progression, and suboptimal sensitivity to conventional systemic therapies, its clinical management remains controversial. To address these challenges, under the guidance of the Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association, authoritative experts in related fields conducted multidisciplinary discussions to revise and update the "Chinese expert consensus on diagnosis and treatment of colorectal cancer with ovarian metastasis (2020 Edition)". This consensus aims to guide and standardize the diagnostic and therapeutic protocols for such patients, establish precise, personalized, and comprehensive treatment goals and strategies, and ultimately enhance the overall diagnosis and treatment standards for colorectal cancer, and prolong survival and improve quality of life for colorectal cancer patients in China.

This study investigates the effects of Dihydroartemisinin (DHA) on the proliferation, migration, apoptosis, and immune-related molecules of colorectal cancer cells, along with the underlying mechanisms involved.

Human colorectal cancer cells HCT116 and RKO were treated with 6 umol·L^-1 and 12 umol·L^-1of DHA, respectively. Cell viability was detected using the CCK-8 assay; colony formation assay was used to detect cell cloning; wound healing assay and Transwell assay were used to evaluate cell migration; the Calcein-AM/PI double staining was used to assess changes in the number of dead cells; Western blot analysis was used to detect changes in apoptosis-related proteins Bcl-2 and Cleaved-caspase3, signal pathway proteins JAK2/p-JAK2 and STAT3/p-STAT3, and immune factors PD-L1 and CD47. Additionally, quantitative Realtime PCR(qRT-PCR) was performed to measure the changes of immune factors PD-L1 and CD47 at the mRNA level.

Compared with the control group, treatment of HCT116 and RKO cells with DHA at concentrations of 6.25、12.5、25、50、100 umol·L^-1 for 48 h results in a significant decrease in cell viability with increasing drug concentration and prolonged treatment duration. Cell proliferation was inhibited by DHA treatment (HCT116: 3.021±0.014 vs. 2.449±0.008, t=8.302, P<0.001; RKO: 2.666±0.006 vs. 2.122±0.025, t=11.26, P<0.001). The cell clone formation count was significantly decreased (HCT116: 252±6.11 vs. 161.7±3.253, t=13.02, P<0.001; RKO: 329.4±9.368 vs. 204±9.818, t=9.241, P<0.001), cell migration ability decreased (HCT116: 26.29%±0.947% vs. 15.2%±1.409%, t=6.533, P<0.01; RKO: 30.59%±1.441% vs. 14.77%±0.39%, t=10.6, P<0.001) and cell death (HCT116: 37.54%±2.128% vs. 58.74%±1.498%, t=8.145, P<0.01; RKO: 23.97%±1.203% vs. 34.02%±2.225%, t=3.973, P<0.05) increased. Western blot results demonstrate that DHA treatment leads to a decrease in Bcl-2 protein levels (HCT116: 1.001±0.002 vs. 0.551±0.07, t=6.419, P<0.01; RKO: 1.001±0.002 vs. 0.827±0.013, t=12.98, P<0.001), an increase in Cleaved-caspase3 protein levels (HCT116: 1.001±0.002 vs. 1.344±0.119, t=2.904, P<0.05; RKO: 1.001±0.002 vs. 1.515±0.086, t=5.995, P<0.01), and reductions in PD-L1 and CD47 protein levels (HCT116: PD-L1: 0.999±0.001 vs. 0.829±0.029, t=5.517, P<0.01, CD47: 1.001±0.002 vs. 0.763±0.083, t=4.883, P<0.01; RKO: PD-L1: 0.995±0.007 vs. 0.885±0.021, t=2.867, P<0.05, CD47: 0.991±0.011 vs. 0.562±0.093, t=4.577, P<0.05), along with a reduction in the levels of p-JAK2 and p-STAT3 (HCT116: p-JAK2: 1.018±0.019 vs. 0.678±0.066, t=4.901, P<0.01, p-STAT3: 0.999±0.002 vs. 0.691±0.092, t=3.351, P<0.05; RKO: p-JAK2: 1.018±0.019 vs. 0.475±0.064, t=7.092, P<0.001, p-STAT3: 0.999±0.002 vs. 0.488±0.091, t=6.926, P<0.001). qRT-PCR analysis further shows that DHA treatment results in decreased mRNA expression of PD-L1 and CD47 (HCT116: PD-L1: 1.002±0.042 vs. 0.888±0.019, t=4.052, P<0.05, CD47: 1±0.003 vs. 0.868±0.014, t=9.098, P<0.001; RKO: PD-L1: 1±0.002 vs. 0.671±0.024, t=13.64, P<0.001, CD47: 1.011±0.02 vs. 0.727±0.02, t=10.07, P<0.001). The addition of the JAK2 agonist Coumermycin A1 counteracts the inhibitory effects of DHA on colorectal cancer cells.

DHA can inhibit the proliferation and migration of colorectal cancer cells, promote apoptosis, and regulate immune-related molecules by inhibiting JAK2/STAT3 signaling pathway.

To investigate the characteristics of the tumor immune microenvironment in colon cancer, identify key immune-related genes, and evaluate their prognostic value, thereby providing evidence for immunotherapy target screening and prognostic stratification.

Based on transcriptomic and somatic mutation data from 514 colon cancer patients in the TCGA database, CIBERSORT and ESTIMATE algorithms were used to calculate immune score, stromal score, and ESTIMATE score. The associations between these scores and patients’ clinical outcomes (e.g., overall survival) as well as various clinicopathological parameters were statistically evaluated. Differentially expressed genes (DEGs) were identified using the limma package and functionally annotated through GO/KEGG enrichment analyses. Somatic mutation analysis was used to identify differentially mutated genes (DMGs), which were cross-analyzed with DEGs to identify key genes associated with tumor-infiltrating immune cells and prognosis. Clinical data and cellular experiments were used to validate the results.

A high immune score was significantly positively correlated with overall survival in colon cancer patients (low/high immune score groups: 140, 51, 17, 7, 3 vs. 309, 93, 15, 5, 2; χ²=6.45, P=0.011), and the immune score significantly decreased with tumor stage progression. A total of 627 immune-related DEGs were identified, mainly enriched in immune pathways such as cytokine–cytokine receptor interaction. Combined with mutation analysis, FN1 and DOCK2 were identified as intersecting key genes with both differential expression and mutation: high expression of FN1 was associated with poor prognosis (P=0.011), increased with tumor stage, and was significantly positively correlated with lymph node and distant metastasis; high expression of DOCK2 had a protective effect (P=0.075), decreased with stage progression, and was negatively correlated with distant metastasis. Experiments showed that FN1 was significantly overexpressed in colon cancer tissues and peripheral blood (P=0.0257, 0.0004), while DOCK2 was significantly under expressed (P=0.0260, P<0.0001). Functional experiments demonstrated that knockdown of FN1 significantly inhibited colorectal cancer cell proliferation (48 h: t=3.58, P=0.0006; 60 h: t=3.66, P=0.0005), invasion (t=3.27, P=0.0404), and colony formation (t=10.98, P=0.0001). In contrast, DOCK2 knockdown promoted these malignant phenotypes (t=−1.94, P=0.0401; t=−9.14, P=0.0002; t=−3.95, P=0.0149).

FN1 and DOCK2 regulate colon cancer progression and prognosis by modulating the tumor immune microenvironment. FN1 serves as a risk factor, while DOCK2 acts as a protective factor, potentially serving as novel targets for immunotherapy and biomarkers for prognostic stratification.

To explore the mechanism of action of sacral nerve stimulation (SNS) in the treatment of slow transit constipation (STC) by observing its effect on the expression of 5-hydroxytryptamine 4 receptor (5-HT₄R) in the colonic tissue of STC mice.

Thirty Kunming mice were randomly divided into normal and modeling groups, with 10 mice in the normal group and 20 mice in the modeling group. The modeling group was gavaged with compound difenocoumarol suspension, and the normal group was fed normally. After the success of the STC mouse model, the modeling group was then divided into the SNS group and the model group. The SNS group received sacral nerve stimulation therapy; the normal group and the model group were subjected to daily acupuncture at the skin site corresponding to the S3 nerve foramen, with a 2-week treatment duration for all groups. After treatment, the fecal moisture content, intestinal propulsion rate, expression of 5-HT₄R protein, 5-HT₄R mRNA expression levels, and c-kit immunohistochemistry in the colon were measured in each group.

Compared with the normal group, the model group showed significantly reduced fecal moisture content (t=22.43, P<0.05) and intestinal propulsion rate (t=12.67, P<0.05), as well as significantly decreased expression of 5-HT₄R protein (t=5.96, P<0.05), 5-HT₄R mRNA (t=9.92, P<0.05), and c-kit protein immunohistochemistry in the colonic tissue (t=5.44, P<0.05). Compared with the model group, the SNS group exhibited significantly increased fecal moisture content (t=19.36, P<0.05) and intestinal propulsion rate (t=7.47, P<0.05), along with significantly increased expression of 5-HT₄R protein (t=4.76, P<0.05), 5-HT₄R mRNA (t=13.74, P<0.05), and c-kit protein immunohistochemistry in the colonic tissue (t=5.39, P<0.05).

Sacral nerve stimulation may alleviate constipation symptoms in STC mice, potentially associated with the upregulation of 5-HT₄R and c-kit expression in colonic tissues, which may promote the proliferation of interstitial cells of Cajal, enhance their cellular function, and ultimately improve intestinal motility.

To analyze the learning curve of transanal minimally invasive surgery (TAMIS).

A retrospective cohort study was conducted to analyze relevant clinical data of 45 patients who had undergo TAMIS by the same group of surgeons in the Sixth Affiliated Hospital of Sun Yat-sen University from July 2016 to October 2024. The learning curve of TAMIS was plotted using the cumulative sum (CUSUM) analysis method and the optimal learning cases was determined according to the peak value of the learning curve. Clinical indicators such as duration of surgery, intraoperative blood loss, positive rate of circumferential margin, length of postoperative hospital stay, and incidence of postoperative complications were compared at different stages.

Forty-five patients had been successfully undergo TAMIS. The optimum curve equation was y=0.030x³-2.856x²+71.555x-138.134, R²=0.954, P<0.05. According to the peak value of the curve, seventeen cases were determined as the minimum cumulative required cases of TAMIS for surgeons to cross the learning curve. Forty-five cases were divided into two groups: the learning improvement group (Group A) of the former 17 cases, and the proficiency group (Group B) of the latter 28 cases. Compared with Group A, Group B had shorter duration of surgery(49.6 min vs. 88.4 min, t=7.170, P<0.001), less intraoperative blood loss(5.0 mL vs. 10.0 mL, Z=-2.384, P=0.017), and shorter length of postoperative hospital stay (3.5 d vs. 6.0 d, Z=-3.006, P=0.003). There was no statistically significant difference in the observation indicators including positive rate of circumferential margin and incidence of postoperative complications between the two groups (P>0.05).

The learning curve of TAMIS can be divided into the two stages: learning improvement stage and mastery stage. Seventeen cases may be the optimal required cases to cross the learning curve of TAMIS for surgeons.

Helicobacter pylori(Hp) is one of the most prevalent gastric pathogens globally, and its eradication effectively reduces the incidence of gastric cancer, peptic ulcers, and related diseases. However, conventional antibiotic therapies, due to their broad-spectrum bactericidal effects, disrupt gut microbiota homeostasis, leading to adverse outcomes such as diarrhea, increased antibiotic resistance, and immune dysfunction. This review systematically explores the bidirectional relationship between Hp eradication therapy and gut microbiota dysbiosis. On one hand, while mainstream bismuth-containing quadruple therapy achieves high eradication rates, it significantly reduces gut microbiota diversity, impairs short-chain fatty acid metabolic pathways, and compromises the protective function of the intestinal barrier. Conversely, Hp infection itself alters the gastric microenvironment through virulence factors, indirectly exacerbating gut microbiota imbalance. Emerging therapies, including vonoprazan-based dual therapy, minocycline-containing regimens, and probiotic adjuvant treatments, mitigate microbiota perturbation but face challenges such as strain-specific efficacy variability and heightened resistance risks. Future strategies should integrate targeted delivery systems, synergistic Chinese-Western medicine approaches, and artificial intelligence to develop personalized regimens that balance eradication efficacy, mucosal repair, and microbiota equilibrium, thereby harmonizing therapeutic outcomes with long-term gut health.

Colorectal cancer stem cells (CCSCs), as a subpopulation of tumorigenic cells with self-renewal and multi-directional differentiation capabilities in colorectal cancer, are the key factors leading to tumor recurrence, metastasis and drug resistance. Recent studies have shown that traditional Chinese medicine can exert anti-colorectal cancer effects through mechanisms such as regulating CCSCs-related signaling pathways, influencing the expression of stemness markers and inhibiting proliferation. This article systematically reviews the research progress of traditional Chinese medicine in regulating CCSCs, providing new strategies and theoretical basis for the treatment of colorectal cancer.

Microorganisms are ubiquitously present in various human organs and play a significant role in the occurrence and development of colorectal cancer. While the gut microbiota has been extensively studied, knowledge about the intratumoral microbiota remains limited. Emerging evidence suggests that the intratumoral microbiota plays a critical role in shaping the tumor microenvironment, particularly in colorectal cancer. These microbes not only contribute to tumor initiation, progression, and metastasis but also modulate therapeutic responses. This review summarizes the current understanding of the intratumoral microbiota in colorectal cancer and its potential implications for enhancing cancer treatment outcomes.

To explore a surgical approach for handling the gastrocolic trunk, referred to as "isolated anatomical dissection of the gastrocolic trunk" and evaluate its safety and efficacy.

This study retrospectively analyzed the clinical data of 25 patients who underwent this technique in the Gastrointestinal Tumor Center of Guangdong Provincial Hospital of Traditional Chinese Medicine from June to December 2023, parameters examined included gastrocolic trunk type, operation time, intraoperative blood loss, gastrocolic trunk exposure time, postoperative complications, postoperative hospital stay, etc.

The mean time to isolate the gastrocolic trunk was (9.5±1.6) min, and the overall mean operative time was (88.1±11.1) min. The estimated bleeding volume at the time of isolation of the gastrocolic trunk was 3.1 (0.5, 8.5)mL, of which 3 cases were greater than 10 mL, of which one case was 12 mL, one case was 13 mL, and one case was 18 mL. The postoperative length of hospital stay was (5±1.5) days, and the mean number of lymph nodes cleared was 22.5±4.5. There were no postoperative complications in any of the 25 cases, and there were no cases of readmission within 30 days.

"Isolated dissection of the gastrocolic Trunk" is a new surgical technique for laparoscopic right hemicolectomy, which is worth further verification and promotion.

Colorectal cancer is a common type of gastrointestinal tumor, for which surgical intervention remains the main treatment approach. Left hemicolectomy presents significant technical challenges. The current mainstream surgical approach is five-port laparoscopic radical resection for left-side colon cancer. The single-incision plus one-port surgery represents a more minimally invasive technique, with primary advantages including reduced abdominal wall trauma, concealed scar, and milder postoperative pain. This article shares the procedure of a single-port plus one laparoscopic radical resection for left colon cancer, aiming to exchange surgical experience.