▲全球结直肠癌发病率和致死率（图片来源：参考资料^[3]）

结语

从1913年科学家发现结直肠癌和遗传有关到现在的100多年里，人类对结直肠癌的理解和认识已发生了质的变化，一系列创新疗法的诞生使晚期结直肠癌患者的中位生存期由5个月提高到今天了的30个月左右。但是结直肠癌仍是全球五大癌症负担之一，其发病率和死亡率分别居第四位、第二位，大约每20个人中有1人会在一生中患上结直肠癌。

而且结直肠癌的高度分子异质性决定了，一种创新靶向疗法只能使一部分患者受益，还有许多患者尚无靶向药可选。不过，目前科学家也在努力探索新型靶向药、疫苗、干细胞治疗等创新疗法，以期对抗这种顽疾。我们期望未来会有更多的创新疗法上市，让结直肠癌患者看到更多的选择和希望。

参考资料:

[1] Avi S. Galler a, et al , (2011), Rectal cancer surgery: A brief history, Surgical Oncology. https://doi.org/10.1016/j.suronc.2010.01.001

[2] C. Richard Boland and Henry T. Lynch. (2014)，The History of Lynch Syndrome. doi: 10.1007/s10689-013-9637-8

[3] Keum, N., & Giovannucci, E. (2019). Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nature Reviews Gastroenterology & Hepatology. doi:10.1038/s41575-019-0189-8

[4] Amirsaeed Sabeti Aghabozorgi, et al.（2018）.Role of Adenomatous Polyposis Coli (APC) gene mutations in the pathogenesis of colorectal cancer; current status and perspectives. Biochimie. https://doi.org/10.1016/j.biochi.2018.11.003

[5] Henry T. Lynch and Jane F. Lynch. (2004) Lynch syndrome: History and current status. Disease Markers. doi:10.1155/2004/460240

[6] Bengt Gustavsson et al.,(2015). A Review of the Evolution of Systemic Chemotherapy in the Management of Colorectal Cancer. Clinical Colorectal Cancer. https://doi.org/10.1016/j.clcc.2014.11.002

[7] Welch, H. G., & Robertson, D. J. (2016). Colorectal Cancer on the Decline — Why Screening Can’t Explain It All. New England Journal of Medicine. doi:10.1056/nejmp1600448.

[8] Snook AE, et al.（2019）.Split tolerance permits safe Ad5-GUCY2C-PADRE vaccine-induced T-cell responses in colon cancer patients. Journal for ImmunoTherapy of Cancer. doi:10.1186/s40425-019-0576-2.

[9] Mark C. Mattar，et al.(2011).Current Management of inflammatory bowel disease and colorectal cancer. Gastrointest Cancer Res. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109885/#B3

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