Page 140 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第46卷第5期
·762 · Journal of Nanjing Medical University（Natural Sciences） 2026年5月

·综 述·

循环肿瘤DNA联合系统性炎症指标预测结直肠癌术后复发的

研究进展

杨浚沫，曾奕淙，周 何 *

川北医学院附属医院胃肠外二科，四川 南充 637000

［摘 要］ 结直肠癌术后复发是影响患者长期生存的主要挑战，实现早期精准预测是制定个体化辅助治疗策略的关键。循环
肿瘤DNA（circulating tumor DNA，ctDNA）和系统性炎症指标（如中性粒细胞⁃淋巴细胞比率）作为两类重要的生物标志物，分别
从肿瘤分子残留和宿主免疫炎症反应角度提供预后信息，但单一指标应用存在一定局限。文章重点探讨二者联合应用的生物
学协同机制与临床预测价值。ctDNA可直接反映分子残留病灶，其预警窗口通常早于影像学复发数个月；而系统性炎症指标
则体现肿瘤相关的免疫微环境状态。二者在“炎症促进ctDNA释放与存续”这一病理生理过程中密切相关。目前，虽然前瞻性
联合研究证据仍在积累，但理论模型与其他癌种的初步研究提示，联合检测有望实现对复发风险更精细的分层，从而指导包括
强化辅助治疗与抗炎干预在内的个体化临床决策。当前该联合策略仍面临检测成本较高、标准化不足以及结果解读复杂等挑
战。未来应通过开展严谨的前瞻性队列研究，整合多组学数据与人工智能分析，构建并验证融合ctDNA与炎症指标的多模态
预测模型，以推动结直肠癌术后复发管理向精准化方向发展。
［关键词］ 结直肠癌；预测模型；复发；生物标志物；炎性指标
［中图分类号］ R735.3 ［文献标志码］ A ［文章编号］ 1007⁃4368（2026）05⁃762⁃09
doi：10.7655/NYDXBNSN251491

Research progress on circulating tumor DNA combined with systemic inflammatory
indicators for predicting postoperative recurrence of colorectal cancer
YANG Junmo，ZENG Yicong，ZHOU He *
Department of Gastrointestinal Surgery（Division II），Affiliated Hospital of North Sichuan Medical College，Nanchong
637000，China

［Abstract］ Recurrence following colorectal cancer（CRC）surgery poses a major challenge to long⁃term patient survival. Early and
accurate prediction of recurrence is essential for formulating individualized adjuvant treatment strategies. Circulating tumor DNA
（ctDNA）and systemic inflammatory markers，such as the neutrophil ⁃ to ⁃ lymphocyte ratio（NLR），serve as two important types of
biomarkers，providing prognostic information from the perspectives of tumor molecular residual disease and host immune⁃inflammatory
responses，respectively. However，the application of either marker alone has certain limitations. This article focuses on exploring the
biological synergistic mechanisms and clinical predictive value of their combined application. ctDNA can directly reflect minimal
residual disease，with its warning window typically occurring several months earlier than radiographic recurrence. Systemic
inflammatory markers，on the other hand，reflect the state of the tumor ⁃ associated immune microenvironment. The two are closely
related in the pathophysiological process of“inflammation promoting the release and persistence of ctDNA”. Currently，although
prospective evidence on their combined use is still accumulating，theoretical models and preliminary studies in other cancer types
suggest that combined detection may enable more refined stratification of recurrence risk，thereby guiding individualized clinical
decisions，including intensified adjuvant therapy and anti⁃inflammatory interventions. At present，this combined strategy still faces
challenges such as high detection costs，insufficient standardization，and complexity in result interpretation. In the future，rigorous
prospective cohort studies should be conducted，integrating multi ⁃ omics data and artificial intelligence analysis to construct and

［基金项目］ 四川省科技计划立项项目（2021YJ0456）
通信作者（Corresponding author），E⁃mail：zhouhe@nsmc.edu.cn（ORCID：0000⁃0002⁃8966⁃6188）
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