Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Tianjin General Surgery Institute, Tianjin, China.
Cancer Med. 2020 Oct;9(20):7637-7645. doi: 10.1002/cam4.3323. Epub 2020 Aug 27.
Colorectal cancers generally consist of multiple subclones. These subclones have their own unique characteristics, resulting in intratumor heterogeneity (ITH). As the discussion of ITH has advanced, a model describing the relationship of ITH to the tumor has gradually emerged. ITH can be divided into two types of intraprimary tumor heterogeneity and intraindividual tumor heterogeneity, the former for further understanding of tumor composition, and the latter for providing more information about evolutionary patterns. With the rapid development of new methods, such as next-generation, polyguanine region sequencing, and Image detection, researchers may unravel the secrets underlying ITH. The higher the ITH of the tumor, the richer the interaction between the subclones maybe, or the greater the chance of the tumor getting more powerful subclones may be, thus increasing the malignant potential of the tumor. Existing evidence suggests that ITH may increase the ability of tumors to resist treatment and can be used as an independent influence on the prognosis of colorectal cancer. We reviewed 80 recent studies to give researchers a new perspective on colorectal cancer. There is still a limited amount of research in this area. Further study of the relationship between ITH and clinical endpoints may lead to the development of new treatment strategies.
结直肠癌通常由多个亚克隆组成。这些亚克隆具有各自独特的特征，导致肿瘤内异质性（ITH）。随着对 ITH 的讨论不断深入，一种描述 ITH 与肿瘤关系的模型逐渐浮现。ITH 可分为原发性肿瘤内异质性和个体内肿瘤异质性两种类型，前者有助于进一步了解肿瘤的组成，后者则为进化模式提供了更多信息。随着新一代、聚鸟嘌呤区测序和图像检测等新技术的快速发展，研究人员或许能够揭开 ITH 的奥秘。肿瘤的 ITH 越高，亚克隆之间的相互作用可能越丰富，或者肿瘤获得更强大亚克隆的机会可能越大，从而增加肿瘤的恶性潜能。现有证据表明，ITH 可能会增加肿瘤对治疗的抵抗力，并可作为影响结直肠癌预后的独立因素。我们回顾了 80 项最近的研究，为研究人员提供了结直肠癌的新视角。该领域的研究仍然有限。进一步研究 ITH 与临床终点之间的关系可能会促使新的治疗策略的发展。
