{"id":35682,"date":"2020-09-16T00:53:07","date_gmt":"2020-09-15T16:53:07","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=35682"},"modified":"2020-09-16T09:17:20","modified_gmt":"2020-09-16T01:17:20","slug":"%e5%a4%a7%e8%85%b8%e7%99%8c%e7%9a%84%e8%aa%8d%e8%ad%98%e3%80%81%e7%af%a9%e6%aa%a2%e5%8f%8a%e9%a0%90%e5%be%8c%e8%a9%95%e4%bc%b0","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=35682","title":{"rendered":"\u5927\u8178\u764c\u7684\u8a8d\u8b58\u3001\u7be9\u6aa2\u53ca\u9810\u5f8c\u8a55\u4f30"},"content":{"rendered":"

\u6839\u64da\u885b\u751f\u798f\u5229\u90e8\u516c\u5e03\u7684\u6700\u65b0\u764c\u75c7\u767c\u751f\u7387\u7d71\u8a08\u8cc7\u6599\u986f\u793a\uff0c\u5927\u8178\u764c\u5df2\u8d8a\u5c45\u6211\u570b\u5341\u5927\u764c\u75c7\u4e4b\u9996\uff08\u7537\u5973\u5408\u8a08\uff09\uff0c\u4e26\u5df2\u9023\u7e8c12\u5e74\u767c\u751f\u4eba\u6578\u6392\u540d\u7b2c\u4e00\uff0c\u8a31\u591a\u4eba\u5e74\u7d00\u8f15\u8f15\u4fbf\u7f79\u60a3\u5927\u8178\u764c\uff0c\u9023\u570b\u5167\u5916\u5f88\u591a\u9054\u5b98\u986f\u8981\u53ca\u540d\u4eba\u4e5f\u6709\u4eba\u7f79\u60a3\u6b64\u75c7\uff0c\u8457\u5be6\u4ee4\u4eba\u8ac7\u5927\u8178\u764c\u8272\u8b8a\u3002\u5728\u672c\u6587\u6211\u5011\u5c07\u63a2\u8a0e\u5927\u8178\u764c\u7684\u75c7\u72c0\u3001\u81f4\u75c5\u56e0\u5b50\u3001\u7be9\u6aa2\u65b9\u6cd5\u53ca\u9810\u5f8c\u8a55\u4f30\u7684\u767c\u5c55\u3002<\/strong><\/span><\/p>\n

\"\"
\u5716\u7247\u4f86\u6e90: Pixabay<\/figcaption><\/figure>\n

\u64b0\u6587\uff0f\u9673\u6df5\u9293<\/strong><\/p>\n

\u25cf\u5927\u8178\u764c\u7684\u8a8d\u8b58<\/strong><\/span><\/p>\n

\u7d50\u8178\u76f4\u8178\u764c\uff08colorectal cancer\uff09\u7c21\u7a31\u5927\u8178\u764c\uff0c\u70ba\u6e90\u81ea\u7d50\u8178<\/a>\uff08colon\uff09\u6216\u76f4\u8178<\/a>\uff08rectum\uff09\u7684\u764c\u75c7<\/a>\uff0c\u56e0\u70ba\u5927\u8178\u7d30\u80de<\/a>\u4e0d\u6b63\u5e38\u7684\u751f\u9577\uff0c\u800c\u53ef\u80fd\u4fb5\u72af\u6216\u8f49\u79fb<\/a>\u81f3\u8eab\u9ad4\u5176\u4ed6\u90e8\u4f4d\u3002\u5927\u8178\u764c\u7684\u767c\u751f\u8207\u606f\u8089\u7684\u589e\u9577\u6709\u5bc6\u5207\u7684\u95dc\u4fc2\uff0c\u7531\u606f\u8089\u6f14\u8b8a\u800c\u6210\u7684\u816b\u7624\u662f\u9020\u6210\u5927\u8178\u764c\u7684\u4e3b\u56e0\uff0c\u800c\u606f\u8089\u7684\u985e\u578b\u53ef\u5206\u70ba\u589e\u751f\u6027\u3001\u817a\u7624\u6027\u53ca\u767c\u708e\u6027\u4e09\u7a2e\u3002\u5927\u8178\u764c\u7684\u75c7\u72c0\u901a\u5e38\u8207\u816b\u7624\u7684\u751f\u9577\u4f4d\u7f6e\u8207\u72c0\u6cc1\u6709\u95dc\uff0c\u4e3b\u8981\u75c7\u72c0\u5305\u62ec\u8179\u90e8\u4e0d\u9069\uff08\u8179\u8139\u6216\u7d5e\u75db\uff09\u3001\u9ad4\u91cd\u6e1b\u8f15\u3001\u7cde\u4fbf\u5e36\u8840\u6216\u9ecf\u6db2\u3001\u6392\u4fbf\u6025\u8feb\u611f\u3001\u6392\u4fbf\u7fd2\u6163\u6539\u8b8a\u3001\u7cde\u4fbf\u5f62\u72c0\u8b8a\u7d30\u53ca\u8ca7\u8840\u3002<\/p>\n

\u5927\u8178\u764c\u7684\u771f\u6b63\u6210\u56e0\u4e26\u672a\u5b8c\u5168\u78ba\u8a8d\uff0c\u76f8\u95dc\u7814\u7a76\u4ecd\u5728\u9032\u884c\u4e2d\uff0c\u4f46\u6839\u64da\u521d\u6b65\u7d71\u8a08\u7d50\u679c\u5f97\u77e5\u5927\u8178\u764c\u75c5\u4eba\u7d04\u670920%\u8207\u5148\u5929\u907a\u50b3\u57fa\u56e0\u6709\u95dc\uff0c80%\u5247\u8207\u5e74\u9f61\u3001\u80a5\u80d6\u3001\u751f\u6d3b\u578b\u614b\u53ca\u98f2\u98df\u7b49\u5f8c\u5929\u56e0\u7d20\u6709\u95dc\uff0c\u5305\u62ec50\u6b72\u4ee5\u4e0a\u7684\u65cf\u7fa4\u3001\u9ad4\u91cd\u8d85\u91cd\uff08BMI\u226724\uff09\u3001\u7f3a\u4e4f\u904b\u52d5\u3001\u5de5\u4f5c\u6642\u9593\u904e\u9577\u3001\u4e0d\u826f\u55dc\u597d\uff08\u5982\u62bd\u83f8\u3001\u559d\u9152\uff09\u53ca\u4e0d\u826f\u98f2\u98df\u7fd2\u6163\uff08\u5982\u55dc\u98df\u9ad8\u52d5\u7269\u6027\u8102\u80aa\u3001\u9ad8\u86cb\u767d\u8cea\u3001\u4f4e\u7e96\u7dad\u3001\u7d05\u8089\u3001\u6cb9\u70b8\u3001\u70ad\u70e4\u53ca\u52a0\u5de5\u985e\u98df\u54c1\uff09\u3002<\/p>\n

\u25cf\u7be9\u6aa2\u65b9\u6cd5<\/strong><\/span><\/p>\n

1.\u7cde\u4fbf\u514d\u75ab\u5316\u5b78\u6e2c\u8a66\uff08Fecal immunochemical test\uff09\uff1a\u9019\u662f\u6700\u666e\u904d\u53ca\u7c21\u4fbf\u7684\u65b9\u6cd5\uff0c\u53ef\u5206\u70ba\u5316\u5b78\u6cd5\u53ca\u514d\u75ab\u6cd5\u7cde\u4fbf\u6f5b\u8840\u6aa2\u67e5\u5169\u7a2e\u3002\u5316\u5b78\u6cd5\u662f\u6aa2\u6e2c\u7cde\u4fbf\u4e2d\u8840\u7d05\u7d20\u7684\u904e\u6c27\u5316\u9176\uff08peroxidase\uff09\u6d3b\u6027\uff0c\u4f46\u82e5\u53d7\u6aa2\u8005\u6709\u75d4\u7621\u3001\u8178\u80c3\u9053\u51fa\u8840\u6216\u98df\u7269\u4e2d\u542b\u6709\u904e\u6c27\u5316\u9176\uff08\u5982\u52d5\u7269\u8840\u3001\u852c\u83dc\u7b49\uff09\uff0c\u4fbf\u6703\u51fa\u73fe\u507d\u967d\u6027\u53cd\u61c9\uff08\u7d0430%\uff09\uff1b\u514d\u75ab\u6cd5\u6aa2\u6e2c\u662f\u4f7f\u7528\u6297\u4eba\u985e\u8840\u7d05\u7d20\u6297\u9ad4\uff08anti-human hemoglobin antibody\uff09\u6aa2\u6e2c\u7cde\u4fbf\u4e2d\u7684\u8840\u7d05\u7d20\uff0c\u7279\u7570\u6027\uff0897%\uff09\u53ca\u6e96\u78ba\u5ea6\uff0885%\uff09\u5747\u8f03\u5316\u5b78\u6cd5\u9ad8\u3002<\/p>\n

2.\u6108\u5275\u6728\u8102\u7cde\u4fbf\u6f5b\u8840\u6e2c\u8a66\uff08Guaiac-based fecal occult blood test\uff09\uff1a\u8207\u7cde\u4fbf\u514d\u75ab\u5316\u5b78\u6e2c\u8a66\u7684\u6f5b\u8840\u6aa2\u67e5\u985e\u4f3c\uff0c\u4f46\u53d7\u6aa2\u8005\u9808\u6539\u8b8a\u98f2\u98df\u53ca\u7528\u85e5\uff0c\u800c\u4e14\u6aa2\u9ad4\u9808\u4f86\u81ea\u65bc\u4e09\u6b21\u7cde\u4fbf\u3002<\/p>\n

3.\u5927\u8178\u93e1\u6aa2\u67e5\uff08Colonoscopy\uff09\uff1a\u9019\u662f\u6700\u76f4\u63a5\u4e14\u53ef\u9760\u7684\u65b9\u6cd5\uff0c\u5167\u8996\u93e1\u5f9e\u809b\u9580\u9032\u5165\u76f4\u8178\uff0c\u7d93\u7531\u4e59\u72c0\u7d50\u8178\u3001\u964d\u7d50\u8178\u3001\u6a6b\u7d50\u8178\u3001\u5347\u7d50\u8178\u3001\u76f2\u8178\u53ca\u5c0f\u8178\u958b\u53e3\u8655\uff0c\u53ef\u5b8c\u6574\u7684\u6aa2\u8996\u6574\u689d\u5927\u8178\u4e00\u6b21\uff0c\u5fc5\u8981\u6642\u9084\u53ef\u76f4\u63a5\u505a\u5207\u7247\u9001\u6aa2\uff0c\u6e96\u78ba\u5ea6\u53ef\u905495%\u4ee5\u4e0a\u3002<\/p>\n

4.\u5f48\u6027\u4e59\u72c0\u7d50\u8178\u93e1\u6aa2\u67e5\uff08Flexible sigmoidoscopy\uff09: \u4e59\u72c0\u7d50\u8178\u93e1\u662f\u4e00\u6839\u6709\u5982\u624b\u6307\u822c\u7684\u6709\u5f48\u6027\u5149\u7e96\u7ba1\uff08\u7d0460\u516c\u5206\uff09\uff0c\u6b64\u7ba1\u63d2\u5165\u809b\u9580\u5f8c\u7d93\u7531\u76f4\u8178\u901a\u5230\u4e59\u72c0\u7d50\u8178\uff0c\u4f5c\u6cd5\u8207\u5927\u8178\u93e1\u985e\u4f3c\uff0c\u7531\u809b\u9580\u53e3\u653e\u5165\u5167\u8996\u93e1\uff0c\u4f46\u6aa2\u67e5\u7bc4\u570d\u53ea\u5230\u4e59\u72c0\u7d50\u8178\u8207\u6a6b\u7d50\u8178\u4ea4\u754c\u8655\uff0c\u6709\u7d0430%\u5927\u8178\u816b\u7624\u7121\u6cd5\u88ab\u7be9\u6aa2\u51fa\u4f86\u3002<\/p>\n

5.\u96fb\u8166\u65b7\u5c64\u865b\u64ec\u5927\u8178\u93e1\uff08CT colonography\uff09\uff1a\u4ea6\u7a31X\u5c04\u7dda\u5927\u8178\u93e1\u6aa2\u67e5\uff0c\u9808\u53e3\u670d\u6216\u6ce8\u5c04\u986f\u5f71\u5291\uff0c\u4f7f\u7528CT\u6383\u63cf\u5100\u5c0d\u5927\u8178\u9032\u884cX\u5c04\u7dda\u6aa2\u67e5\uff0c\u5229\u7528X\u5149\u63cf\u7e6a\u7acb\u9ad4\u7684\u5f71\u50cf\uff0c\u5448\u73fe\u7684\u8cc7\u8a0a\u9060\u591a\u65bc\u5e73\u9762\u7684X\u5149\u7247\u3002<\/p>\n

6.\u591a\u76ee\u6a19\u7cde\u4fbfDNA\u6e2c\u8a66\uff08Multitargeted stool DNA test\uff09\uff1a\u5206\u96e2\u51fa\u7cde\u4fbf\u4e2d\u816b\u7624\u7d30\u80de\u7684DNA\uff0c\u4e26\u5206\u6790\u5176\u662f\u5426\u6709\u81f4\u764c\u904e\u7a0b\u7522\u751f\u7684\u8b8a\u5316\u5b58\u5728\u3002<\/p>\n

7.\u96d9\u91cd\u5c0d\u6bd4\u92c7\u5291\u704c\u8178\uff08Double contrast barium enema\uff09\uff1a\u7531\u809b\u9580\u704c\u5165\u92c7\u5291\uff0c\u518d\u7528\uff38\u5149\u7167\u76f8\u6aa2\u67e5\u5927\u8178\u5167\u662f\u5426\u6709\u4e0d\u6b63\u5e38\u7684\u75c5\u7076\uff08\u5982\u816b\u7624\u3001\u72f9\u7a84\u53ca\u61a9\u5ba4\u7b49\uff09\u3002<\/p>\n

\u25cf\u9810\u5f8c\u7684\u8a55\u4f30<\/strong><\/span><\/p>\n

\u81e8\u5e8a\u4e0a\uff0c\u5927\u8178\u764c\u5fa9\u767c\u7387\u6975\u9ad8\uff0c\u6545\u60a3\u8005\u7d93\u904e\u6cbb\u7642\u5f8c\u7684\u9810\u5f8c\u8a55\u4f30\u5341\u5206\u91cd\u8981\uff0c\u4f46\u50b3\u7d71\u7684\u9810\u5f8c\u8a55\u4f30\u6210\u6548\u4e26\u4e0d\u5982\u9810\u671f\u7406\u60f3\uff0c\u5be6\u6709\u958b\u767c\u65b0\u578b\u8a55\u4f30\u65b9\u6cd5\u7684\u9700\u8981\uff0c\u6700\u8fd1\u7684\u9810\u5f8c\u8a55\u4f30\u65b9\u6cd5\u767c\u5c55\u5982\u4e0b:<\/p>\n

\u57282019\u5e74\uff0c\u4e2d\u570b\u7814\u7a76\u4eba\u54e1\u85c9\u7531\u8a55\u4f30\u5927\u8178\u764c\u7b2c\u4e00\u5230\u4e09\u671f\u7684\u60a3\u8005\u7684\u816b\u7624\u8f49\u9304\u9ad4\uff08transcriptome\uff09\u800c\u958b\u767c\u51fa\u65b0\u578b\u7684\u514d\u75ab\u98a8\u96aa\u8a55\u5206\u6a21\u578b\u3002\u4ed6\u5011\u6bd4\u8f03870\u500b\u5927\u8178\u764c\u60a3\u8005\u548c70\u500b\u6b63\u5e38\u5c0d\u7167\u7d44\u4eba\u54e1\u6aa2\u9ad4\u7684\u514d\u75ab\u7d30\u80de\u7d44\u6210\uff0c\u8a2d\u8a08\u4e86\u5177\u6709\u5f88\u9ad8\u7279\u7570\u6027\u548c\u654f\u611f\u5ea6\u7684\u8a3a\u65b7\u514d\u75ab\u98a8\u96aa\u8a55\u5206\uff08diagnostic immune risk score, dIRS\uff09\u6a21\u578b\uff0c\u9084\u5efa\u7acb\u4e86\u9810\u5f8c\u514d\u75ab\u98a8\u96aa\u8a55\u5206\uff08prognostic immune risk score, pIRS\uff09\u6a21\u578b\uff0c\u9019\u662f\u6bcf\u500b\u7cfb\u5217\u4e2d\u7121\u5fa9\u767c\u751f\u5b58\uff08relapse-free survival\uff09\u7684\u7368\u7acb\u9810\u5f8c\u56e0\u5b50\uff0c\u9810\u5f8c\u8a55\u4f30\u50f9\u503c\u512a\u65bcTNM\u5206\u671f\uff08tumor, node, metastasis stage\uff09\uff0c\u800c\u4e14pIRS\u5c55\u73fe\u51fa\u8f03\u9ad8\u7684\u9810\u6e2c\u5fa9\u767c\u98a8\u96aa\u6e96\u78ba\u5ea6\uff0c\u6bd4TNM\u5206\u671f\u6709\u66f4\u9ad8\u7684\u6548\u76ca\uff0c\u4e26\u5177\u6709\u64ec\u5408\u826f\u597d\u7684\u6821\u6e96\u66f2\u7dda\uff08well-fitted calibration curve\uff09\u3002\u7814\u7a76\u7d50\u679c\u986f\u793adIRS\u548cpIRS\u6a21\u578b\u76f8\u7576\u5177\u6709\u6f5b\u529b\u7528\u65bc\u5927\u8178\u764c\u7684\u8a3a\u65b7\u548c\u9810\u5f8c\u7684\u9810\u6e2c\uff0c\u53ef\u4ee5\u63d0\u4f9b\u7dca\u6025\u7684\u7d9c\u5408\u81e8\u5e8a\u8a0a\u606f\uff0c\u4ee5\u6539\u5584\u5927\u8178\u764c\u60a3\u8005\u7684\u500b\u4eba\u5316\u6cbb\u7642\u3002<\/p>\n

\u57282019\u5e74\uff0c\u8377\u862d\u7814\u7a76\u4eba\u54e1\u5229\u7528\u5fae\u8840\u7ba1\u5bc6\u5ea6\uff08microvessel density, MVD\uff0c\u53ef\u4f5c\u70ba\u8840\u7ba1\u589e\u751f\u7684\u884d\u751f\u6a19\u8a18\u7269\uff0c\u5df2\u77e5\u8207\u5e7e\u7a2e\u764c\u75c7\u7684\u4e0d\u826f\u9810\u5f8c\u6709\u95dc\uff0c\u4f46\u76ee\u524d\u4ecd\u7121\u6cd5\u76f4\u63a5\u6e2c\u91cf\uff09\u5728\u8a55\u4f30MVD\u5728\u7b2c\u4e8c\u671f\u548c\u7b2c\u4e09\u671f\u5927\u8178\u764c\u60a3\u8005\u7684\u9810\u5f8c\u50f9\u503c\u53ca\u5176\u8207\u816b\u7624\u57fa\u8cea\u767e\u5206\u6bd4\uff08tumor stroma percentage\uff09\u7684\u95dc\u4fc2\u3002\u4ed6\u5011\u767c\u73fe\u8207\u7b2c\u4e8c\u671f\u5927\u8178\u764c\u60a3\u8005\u76f8\u6bd4\uff0c\u7b2c\u4e09\u671f\u60a3\u8005\u7684MVD\u66f4\u9ad8\uff0c\u6240\u4ee5MVD\u4f3c\u4e4e\u662f\u8207\u7b2c\u4e8c\u671f\u60a3\u8005\u7684\u4e0d\u826f\u7121\u75c5\u751f\u5b58\u671f\uff08disease free survival, DFS\uff09\u76f8\u95dc\u7684\u7368\u7acb\u9810\u5f8c\u56e0\u7d20\uff08independent prognostic factor\uff09\uff1b\u7b2c\u4e09\u671f\u60a3\u8005\u82e5\u63a5\u53d7\u8f14\u52a9\u5316\u7642\uff08adjuvant chemotherapy\uff09\u6703\u5177\u6709\u66f4\u597d\u7684DFS\uff0c\u4f46\u9019\u7a2e\u89c0\u5bdf\u53ef\u80fd\u5177\u6709\u7279\u6b8a\u7684\u81e8\u5e8a\u610f\u7fa9\uff0c\u4ecd\u6709\u5f85\u9032\u4e00\u6b65\u9a57\u8b49\u3002<\/p>\n

 <\/strong><\/p>\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong><\/p>\n

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  1. Benson AB, Venook AP, Al-Hawary MM, Cederquist L, Chen YJ, Ciombor KK, Cohen S, Cooper HS, Deming D, Engstrom PF, Garrido-Laguna I, Grem JL, Grothey A, Hochster HS, Hoffe S, Hunt S, Kamel A, Kirilcuk N, Krishnamurthi S, Messersmith WA, Meyerhardt J, Miller ED, Mulcahy MF, Murphy JD, Nurkin S, Saltz L, Sharma S, Shibata D, Skibber JM, Sofocleous CT, Stoffel EM, Stotsky-Himelfarb E, Willett CG, Wuthrick E, Gregory KM, Freedman-Cass DA. NCCN Guidelines Insights: Colon Cancer, Version 2.2018. J Natl Compr Canc Netw. 2018 Apr;16(4):359-369. doi: 10.6004\/jnccn.2018.0021.<\/li>\n
  2. Colon Cancer.<\/a> Am Fam Physician. 2018 May 15;97(10): Online.<\/li>\n
  3. Zhou R, Zhang J, Zeng D, Sun H, Rong X, Shi M, Bin J, Liao Y, Liao W. Immune cell infiltration as a biomarker for the diagnosis and prognosis of stage I-III colon cancer.<\/a> Cancer Immunol Immunother. 2019 Mar;68(3):433-442. doi: 10.1007\/s00262-018-2289-7. Epub 2018 Dec 19.<\/li>\n
  4. den Uil SH, van den Broek E, Coup\u00e9 VMH, Vellinga TT, Delis-van Diemen PM, Bril H, Belt EJT, Kranenburg O, Stockmann HBAC, Belien JAM, Meijer GA, Fijneman RJA. Prognostic value of microvessel density in stage II and III colon cancer patients: a retrospective cohort study.<\/a> BMC Gastroenterol. 2019 Aug 16;19(1):146. doi: 10.1186\/s12876-019-1063-4.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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