结直肠癌实验室诊断技术迭代：从早筛优化到MRD精准监测

doi:10.3969/j.issn.1673-8640.2026.04.001

摘要/Abstract

摘要：

结直肠癌是中国高发的消化道恶性肿瘤，早期诊断率不足、术后复发风险高是制约患者预后提升的关键瓶颈。近年来，以粪便、血液为样本的无创检测技术快速发展，为结直肠癌早期筛查、疗效评估和全程疾病管理提供了全新方向及可行路径。文章围绕粪便多标志物联合检测、血清新型分子标志物、基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）技术、预后预测模型构建和微小残留病（MRD）动态监测展开述评，系统梳理无创检测在结直肠癌早筛、诊断、预后评估及复发监测中的应用进展，总结现有技术优势、临床应用瓶颈和转化发展前景。

关键词: 实验室诊断, 结直肠癌, 质谱技术, 生物标志物, 早期诊断, 预后评估, 监测

Abstract:

Colorectal cancer is a highly prevalent gastrointestinal malignancy in China. Insufficient early diagnosis and high postoperative recurrence risk represent critical bottlenecks restricting the improvement of patient prognosis. In recent years，the rapid development of non-invasive determination technologies using feces and blood samples has provided new directions and feasible approaches for the early screening，therapeutic efficacy evaluation and overall disease management of colorectal cancer. This review focuses on the advances in combined determination of fecal multi-biomarkers，new serum molecular biomarkers，matrix-assisted laser desorption/ionization time-of-flight mass spectrometry（MALDI-TOF MS）technology，construction of prognostic prediction models and dynamic monitoring of minimal residual disease（MRD）. It systematically summarizes the application progress of non-invasive determination in early screening，diagnosis，prognostic evaluation and recurrence monitoring of CRC，as well as the advantages of current technologies，bottlenecks in clinical application and future research prospects.

Key words: Laboratory diagnosis, Colorectal cancer, Mass spectrometry, Biomarker, Early diagnosis, Prognostic evaluation, Monitoring

中图分类号:

R446.1

翁文浩. 结直肠癌实验室诊断技术迭代：从早筛优化到MRD精准监测[J]. 检验医学, 2026, 41(4): 309-317.

WENG Wenhao. Iteration of laboratory diagnostic technologies for colorectal cancer：from early screening optimization to precise monitoring of MRD[J]. Laboratory Medicine, 2026, 41(4): 309-317.

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