Xu Xin-Xin, Gao Yun-He, Du Cheng-Zhou, Gao Xiao-Xin, Chen Peng, Fan Rui-Fang, Li Hong-Tao, Qiao Zhi
Department of General Surgery & Institute of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Department of General Surgery, The 940 Hospital of Joint Logistics Support Force of Chinese PLA, Lanzhou 730050, Gansu Province, China.
World J Gastrointest Oncol. 2025 Jun 15;17(6):106316. doi: 10.4251/wjgo.v17.i6.106316.
Lynch syndrome (LS), an autosomal dominant genetic disorder, is distinguished by germline mutations in the DNA mismatch repair genes, including . These mutations confer an elevated risk for the development of colorectal cancer (CRC) and an array of other malignancies. Timely detection, facilitated by genetic profiling and stringent molecular surveillance, is crucial. It enables the implementation of customized therapeutic strategies, which have the potential to markedly enhance patient outcomes. Despite its significant public health impact, LS is frequently underdiagnosed, underscoring the necessity for increased vigilance and the adoption of precision medicine tactics.
This case presentation focuses on a 54-year-old male patient with a strong familial predisposition to colon cancer, who was identified to have LS-associated multiple colorectal neoplasms. Utilizing a comprehensive, multidisciplinary therapeutic strategy that encompassed precision medicine, immunotherapy with pembrolizumab, and stringent molecular residual disease monitoring, we effectively managed his advanced CRC. This tailored approach led to the achievement of sustained clinical remission exceeding 30 months, illustrating the promise of personalized treatment protocols in optimizing outcomes for individuals with LS and associated colorectal malignancies.
A synergistic, multidisciplinary approach is essential for managing LS-associated CRC, advocating for personalized care pathways in precision medicine.
林奇综合征(LS)是一种常染色体显性遗传病,其特征是DNA错配修复基因发生种系突变,包括……。这些突变会增加患结直肠癌(CRC)和一系列其他恶性肿瘤的风险。通过基因分析和严格的分子监测实现及时检测至关重要。这使得能够实施定制的治疗策略,有可能显著改善患者的治疗效果。尽管LS对公共卫生有重大影响,但它经常被漏诊,这凸显了提高警惕和采用精准医学策略的必要性。
本病例报告聚焦于一名54岁男性患者,他有很强的结肠癌家族易感性,被确诊患有与LS相关的多发性结直肠肿瘤。我们采用了一种综合的多学科治疗策略,包括精准医学、帕博利珠单抗免疫治疗以及严格的分子残留病监测,有效管理了他的晚期CRC。这种量身定制的方法实现了超过30个月的持续临床缓解,说明了个性化治疗方案在优化LS及相关结直肠恶性肿瘤患者治疗效果方面的前景。
协同的多学科方法对于管理与LS相关的CRC至关重要,提倡在精准医学中采用个性化护理途径。