Krishnan K, Ruffin M T, Brenner D E
Department of Internal Medicine, East Tennessee State University, Johnson City, USA.
Hematol Oncol Clin North Am. 1998 Oct;12(5):1079-113, viii. doi: 10.1016/s0889-8588(05)70042-3.
Colon cancer is a common malignancy in the westernized world and is incurable in its advanced stages. This article summarizes the currently available information on colorectal cancer chemoprevention. A brief outline of the incidence and etiologic factors is followed by a discussion of the evidence on which chemopreventive strategies for colon cancer are modeled. This includes a description of the development of surrogate endpoint biomarkers and experimental models to study colorectal cancer chemopreventives, a review of the promising colorectal cancer chemopreventives, and a discussion of the issues to be addressed in the design of future chemoprevention trials. The article concludes with an emphasis on the development and validation of biomarkers and selection of high-risk cohorts using genetic and epidemiologic tools as the main goals of future colon cancer chemoprevention trials before large-scale, risk-reduction trials are conducted.
结肠癌是西方世界常见的恶性肿瘤，晚期无法治愈。本文总结了目前关于结直肠癌化学预防的可用信息。首先简要概述发病率和病因因素，随后讨论作为结肠癌化学预防策略依据的证据。这包括描述替代终点生物标志物的发展以及用于研究结直肠癌化学预防剂的实验模型，综述有前景的结直肠癌化学预防剂，并讨论未来化学预防试验设计中需要解决的问题。文章最后强调，在进行大规模降低风险试验之前，将生物标志物的开发和验证以及使用遗传和流行病学工具选择高危人群作为未来结肠癌化学预防试验的主要目标。
