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08 June 2024, Volume 51 Issue 6 Previous Issue    Next Issue

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Clinical value of serum miR-106b-5p and miR-760 combined with low-dose spiral CT in the diagnosis of early lung cancer Liu Na, Kou Jieli, Yang Feng, Liu Taotao, Li Danping, Han Junrui, Yang Lizhou 2024, 51 (6):  321-325.  doi: 10.3760/cma.j.cn371439-20240215-00055 Abstract ( 65 )   HTML ( 9 )   PDF (721KB) ( 40 )   Save Objective To investigate the levels of microRNA （miR）-106b-5p and miR-760 in the serum of early lung cancer patients， and the clinical value of the combination of them and low-dose spiral CT in the diagnosis of early lung cancer. Methods Ninety early lung cancer patients （lung cancer group） who underwent treatment in Cangzhou People's Hospital of Hebei Province from January 2022 to March 2023 were collected as research subjects， meantime， 90 patients with benign pulmonary lesions （benign pulmonary nodules） diagnosed by pathology were selected as the control group. The levels of miR-106b-5p and miR-760 in the serum of two groups were compared， the results of low-dose spiral CT examination were analyzed； receiver operating characteristic curve was drawn to determine the optimal cut-off values of serum miR-106b-5p and miR-760； four grid table method was applied to analyze the diagnostic efficacy of serum miR-106b-5p， miR-760 combined with low-dose spiral CT for early lung cancer. Results The level of miR-106b-5p in lung cancer group was higher than that in control group （1.39±0.31 vs. 1.04±0.30）， serum miR-760 level was lower than that in control group （0.75±0.24 vs. 1.02±0.26）， with statistically significant differences （t=7.70， P<0.001； t=7.24， P<0.001）. The area under curve （AUC） of miR-106b-5p， miR-760 and low-dose spiral CT in the diagnosis of early lung cancer was 0.83， 0.81 and 0.82， the accuracy was 76.67%， 77.22% and 81.67%， the sensitivity was 84.44%， 81.11% and 76.67%， and the specificity was 68.89%， 73.33% and 86.67%， respectively. The AUC， accuracy， sensitivity， and specificity of serum miR-106b-5p， miR-760 combined with low-dose spiral CT in diagnosing early lung cancer were 0.96， 90.00%， 94.44%， and 85.56%， respectively. The accuracy of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p， miR-760 and low-dose spiral CT （χ2=11.52， P=0.001； χ2=10.72， P=0.001； χ2=5.14， P=0.023）， the sensitivity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p， miR-760 and low-dose spiral CT （χ2=4.77， P=0.029； χ2=7.46，P=0.006； χ2=11.51， P=0.001）， the specificity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p， miR-760 （χ2=7.11， P=0.008； χ2=4.12， P=0.042）. Conclusion The serum level of miR-106b-5p is significantly increased in early lung cancer patients， while the serum level of miR-760 is significantly reduced. The combination of miR-106b-5p， miR-760 and low-dose spiral CT has high diagnostic value for early lung cancer. Figures and Tables | References | Related Articles | Metrics

Efficacy of consolidation chemotherapy after radical radiotherapy and chemotherapy for stage Ⅲ-ⅣA esophageal squamous cell carcinoma： a real-world clinical study Qian Xiaotao, Shi Ziyi, Hu Ge, Wu Xiaowei 2024, 51 (6):  326-331.  doi: 10.3760/cma.j.cn371439-20230818-00056 Abstract ( 72 )   HTML ( 16 )   PDF (1048KB) ( 36 )   Save Objective To explore the efficacy of consolidation chemotherapy after radical radiotherapy and chemotherapy in stage Ⅲ-ⅣA esophageal squamous cell carcinoma （ESCC） patients in the real world. Methods The clinical data of 139 patients with stage Ⅲ-ⅣA ESCC who underwent radical radiotherapy and chemotherapy from January 1， 2018 to December 31， 2022 in Hefei Cancer Hospital， Chinese Academy of Sciences were retrospectively analyzed. Patients were divided into a control group （n=85） and a consolidation chemotherapy group （n=54） based on whether they underwent consolidation chemotherapy after radical radiotherapy and chemotherapy. The objective response rate （ORR）， disease control rate （DCR）， progression-free survival （PFS）， and overall survival （OS） between the two groups were compared. The Kaplan-Meier method was used to draw survival curves and log-rank tests were conducted. The Cox proportional risk model was used for univariate and multivariate analysis. Results The ORR of the control group and the consolidation chemotherapy group were 44.71% （38/85） and 66.67% （36/54）， respectively， with a statistically significant difference （χ2=5.54， P=0.018）； the DCR were 70.59% （60/85） and 87.04% （47/54）， respectively， with a statistically significant difference （χ2=5.04， P=0.025）. The median PFS of the two groups of patients were 9.0 and 13.1 months， respectively， with a statistically significant difference （χ2=12.74， P<0.001）； the median OS were 15.0 and 20.6 months， respectively， with a statistically significant difference （χ2=24.75， P<0.001）. The median OS of ESCC patients in two subgroups of cT3-4N1-3M0 were 16.0 and 30.8 months， respectively， with a statistically significant difference （χ2=23.49， P<0.001）. Univariate analysis showed that tumor length （HR=1.57， 95%CI： 1.04-2.36， P=0.032）， objective response （HR=0.08， 95%CI： 0.04-0.17， P<0.001）， and consolidation chemotherapy （HR=0.32， 95%CI： 0.20-0.51， P<0.001） were all influencing factors for OS in ESCC patients undergoing radical radiotherapy and chemotherapy in stages Ⅲ-ⅣA. Multivariate analysis showed that tumor length （HR=1.59， 95%CI： 1.05-2.43， P=0.030）， objective response （HR=0.05， 95%CI： 0.02-0.10， P<0.001）， and consolidation chemotherapy （HR=0.22， 95%CI： 0.13-0.36， P<0.001） were all independent influencing factors for OS in stage Ⅲ-ⅣA ESCC patients undergoing radiotherapy and chemotherapy. In terms of safety， the consolidation chemotherapy group experienced 7 adverse reactions mainly gastrointestinal reaction and leukopenia， including 5 cases of grade 1-2 and 2 cases of grade 3-4； 22 cases of adverse reactions occurred in the control group including 16 cases of grade 1-2 and 6 cases of grade 3-4 mainly including neutropenia, thrombocytopenia, anemia and digestive tract reaction. The incidence rates of adverse reactions in the two groups were 12.96% （7/54） and 25.88% （22/85）， respectively， with no statistically significant difference （χ2=3.34， P=0.068）. Conclusion After radical radiotherapy and chemotherapy， consolidation chemotherapy can significantly improve the prognosis of stage Ⅲ-ⅣA ESCC patients， and the overall adverse reactions are controllable. Figures and Tables | References | Related Articles | Metrics

Analysis of the efficacy and prognosis of neoadjuvant therapy for locally advanced resectable esophageal cancer Yang Mi, Bie Jun, Zhang Jiayong, Deng Jiaxiu, Tang Zuge, Lu Jun 2024, 51 (6):  332-337.  doi: 10.3760/cma.j.cn371439-20240304-00057 Abstract ( 75 )   HTML ( 20 )   PDF (1076KB) ( 50 )   Save Objective To analyze the real clinical effects and prognosis of neoadjuvant therapy for locally advanced resectable esophageal cancer. Methods Two hundred and one patients with locally advanced resectable esophageal cancer who underwent different neoadjuvant treatments at Nanchong Central Hospital of Sichuan Province from January 2019 to December 2021 were retrospective analyzed. Patients were divided into neoadjuvant chemoradiotherapy group （n=87）， neoadjuvant immunochemotherapy group （n=69）， and neoadjuvant chemotherapy group （n=45） according to the different methods of neoadjuvant therapy. Patients underwent surgical treatment 4-6 weeks after completing neoadjuvant therapy. The postoperative pathological response of three groups of patients were compared. Kaplan-Meier method was used to draw survival curves. Log-rank tests were performed to analyze overall survival （OS） rate， local recurrence-free survival （LRFS） rate， and distant metastasis-free survival （DMFS） rate in three groups of patients. Results The pathological complete response rates of the neoadjuvant chemoradiotherapy group， neoadjuvant immunochemotherapy group and neoadjuvant chemotherapy group were 33.3% （29/87）， 40.6% （28/69） and 13.3% （6/45）， respectively， with a statistically significant difference （χ2=9.68， P=0.008）. The pathological complete response rates in the neoadjuvant chemoradiotherapy group and neoadjuvant immunochemotherapy group were higher than that in the neoadjuvant chemotherapy group， with statistically significant differences （χ2=6.09， P=0.014； χ2=9.66， P=0.002）； there was no statistically significant difference between the neoadjuvant chemoradiotherapy group and the neoadjuvant immunochemotherapy group （χ2=0.87， P=0.351）. The major pathologic response rates of the three groups were 58.6% （51/87）， 59.4% （41/69） and 31.1% （14/45）， respectively， with a statistically significant difference （χ2=10.89， P=0.004）. The major pathologic response rates of the neoadjuvant chemoradiotherapy group and neoadjuvant immunochemotherapy group were significantly higher than that of the neoadjuvant chemotherapy group， with statistically significant differences （χ2=8.98， P=0.003； χ2=8.74， P=0.003）； there was no statistically significant difference between the neoadjuvant chemoradiotherapy group and the neoadjuvant immunochemotherapy group （χ2=0.10， P=0.920）. The 3-year OS rates of the three groups were 43.7%， 42.0% and 33.3%， respectively， with no statistically significant difference （χ2=0.79， P=0.347）. The 3-year LRFS rates of the three groups were 67.8%， 66.7% and 46.7%， respectively， with a statistically significant difference （χ2=7.58， P=0.023）， the LRFS rates in the neoadjuvant chemoradiotherapy group and neoadjuvant immunochemotherapy group were significantly higher than that in the neoadjuvant chemotherapy group， with statistically significant differences （χ2=4.17， P=0.041； χ2=4.15， P=0.042）； there was no statistically significant difference in LRFS rates between the neoadjuvant chemoradiotherapy group and the neoadjuvant immunochemotherapy group （χ2=0.01， P=0.923）. The 3-year DMFS rates of the three groups were 37.9%， 37.7% and 28.9%， respectively， with no statistically significant difference （χ2=0.14， P=0.707）. Conclusion Different neoadjuvant therapies have different therapeutic effects in the treatment of locally advanced resectable esophageal cancer， neoadjuvant chemoradiotherapy and neoadjuvant immunochemotherapy can achieve a better pathological response rates and LRFS rates. Figures and Tables | References | Related Articles | Metrics

Diagnostic value of Hp-IgG antibody combined with serum DKK1 and sB7-H3 in early gastric cancer Yuan Jian, Huang Yanhua 2024, 51 (6):  338-343.  doi: 10.3760/cma.j.cn371439-20240108-00058 Abstract ( 60 )   HTML ( 13 )   PDF (920KB) ( 40 )   Save Objective To investigate the diagnostic value of Helicobacter pylori-immunoglobulin G （Hp-IgG） antibody combined with serum secretory protein Dikkopf-associated protein 1 （DKK1） and soluble B7 homolog 3 （sB7-H3） in early gastric cancer （EGC）. Methods Forty-eight patients with EGC admitted to Nantong Haimen People's Hospital of Jiangsu Province from June 2020 to August 2023 were selected as the study objects （EGC group）. Fifty patients with chronic atrophic gastritis （CAG） diagnosed in the same period were selected as CAG group， and 58 healthy subjects were selected as control group. Hp-IgG antibody was detected by colloidal gold method， and serum DKK1， sB7-H3 levels were determined by enzyme-linked immunosorbent assay. The value of serum Hp-IgG antibody， DKK1 and sB7-H3 in differential diagnosis of CAG and EGC was analyzed by receiver operating characteristic （ROC） curve， and the consistency of differential diagnosis was evaluated by Kappa consistency test. Results The positive rates of Hp-IgG antibody in the control group， CAG group， and EGC group were 36.21% （21/58）， 72.00% （36/50）， and 89.58% （43/48）， respectively. The levels of DKK1 in the three groups were （13.78±3.35）， （21.36±4.52）， and （38.86±7.24） μg/L， respectively， and the levels of sB7-H3 were （7.63±1.59）， （12.34±3.64）， and （25.35±5.27） μg/L， respectively. There were statistically significant differences （χ2=34.51， P<0.001； F=316.95， P<0.001； F=314.22， P<0.001）. Compared with the control group， the positive rates of Hp-IgG antibody， DKK1 and sB7-H3 levels were all higher in the CAG group and EGC group （all P<0.05）. Compared with the CAG group， the positive rates of Hp-IgG antibody， as well as the levels of DKK1 and sB7-H3 were all higher in the EGC group （all P<0.05）. Among the CAG patients， 36 had positive Hp-IgG antibody and 14 had negative results. The levels of DKK1 were （22.18±4.84）， （16.33±3.57） μg/L in the positive and negative patients， respectively， and the levels of sB7-H3 were （12.83±3.84）， （9.33±2.32） μg/L， respectively. There were statistically significant differences （t=4.10， P<0.001； t=3.18， P=0.003）. There were 43 positive and 5 negative cases of Hp-IgG antibody in EGC patients， with serum DKK1 levels of （39.66±7.61） μg/L and （30.05±5.23） μg/L， and sB7-H3 levels of （26.18±5.62） μg/L and （16.24±4.25） μg/L， respectively， and there were statistically significant differences （t=2.74， P=0.009； t=3.82， P<0.001）. ROC curve showed that， the area under the curve （AUC） of Hp-IgG antibody for differential diagnosis of CAG and EGC was 0.81 （95%CI： 0.72-0.88）， with a sensitivity of 72.00% and a specificity of 89.58%， while the DKK1 AUC for the differential diagnosis of CAG and EGC was 0.90 （95%CI： 0.82-0.95）， and the optimal cutoff value was 28.32 μg/L， with a sensitivity of 70.00% and a specificity of 95.83%； sB7-H3 AUC for the differential diagnosis of CAG and EGC was 0.86 （95%CI： 0.78-0.92）， and the optimal cutoff value was 16.44 μg/L， with a sensitivity of 70.00% and a specificity of 95.83%； the AUC of the three combined for the differential diagnosis of CAG and EGC was 0.95 （95%CI： 0.89-0.98）， with a sensitivity of 90.00% and a specificity of 87.50%； and the combination of the three was superior to each of the Hp-IgG antibody， DKK1， and sB7-H3 alone for the differential diagnosis of CAG and EGC （Z=3.62， P<0.001； Z=2.13， P=0.035； Z=2.69， P=0.016）. The Kappa consistency test showed that the serum Hp-IgG antibody combined with DKK1 and sB7-H3 for the differential diagnosis of CAG and EGC was in better agreement with histopathological examination （Kappa=0.78）. Conclusion Hp-IgG antibody positive rate， serum DKK1 and sB7-H3 levels of EGC patients are high， and the combination of the three tests is more effective in the differential diagnosis of CAG and EGC. Figures and Tables | References | Related Articles | Metrics

Study on the relationship between serum miR-24-3p， H2AFX and clinical pathological features and postoperative recurrence in liver cancer patients Chen Hongjian, Zhang Suqing 2024, 51 (6):  344-349.  doi: 10.3760/cma.j.cn371439-20240115-00059 Abstract ( 55 )   HTML ( 9 )   PDF (729KB) ( 25 )   Save Objective To explore the relationship between serum microRNA （miR）-24-3p， H2A histone family member X （H2AFX） and clinical pathological features and postoperative recurrence in liver cancer patients. Methods A total of 108 newly diagnosed liver cancer patients admitted to Tumor Hospital Affiliated to Nantong University from March 2018 to March 2022 were regarded as the liver cancer group. Eighty-six patients with benign liver lesions who visited our hospital during the same period were selected as the benign lesion group， and 64 healthy individuals who underwent physical examinations were selected as the control group. Quantitative real-time PCR method was applied to detect and analyze the levels of serum miR-24-3p and H2AFX mRNA in each group. The serum miR-24-3p and H2AFX levels in patients with recurrent and non-recurrent liver cancer were compared， and the comparison of clinicopathological characteristics of patients with liver cancer with different serum miR-24-3p and H2AFX levels was conducted. Logistic regression was applied to analyze the risk factors affecting postoperative recurrence in liver cancer patients. Results To the end of follow-up， of the 108 patients with liver cancer， 46 relapsed. The serum miR-24-3p levels in control group， benign lesion group， and liver cancer group were 1.01±0.23， 0.79±0.21 and 0.55±0.13， respectively， with a statistically significant difference （F=125.86， P<0.001）， serum miR-24-3p level in benign lesion group and liver cancer group was lower than that in control group （both P<0.05）， and serum miR-24-3p level in liver cancer group was lower than that in benign lesion group （P<0.05）. The serum H2AFX mRNA levels in control group， benign lesion group， and liver cancer group were 1.02±0.25， 1.27±0.31 and 1.59±0.37， respectively， with a statistically significant difference （F=65.40， P<0.001）， serum miR-24-3p level in benign lesion group and liver cancer group were higher than that in control group （both P<0.05）， and serum miR-24-3p level in liver cancer group was higher than that in benign lesion group （P<0.05）. There were statistically significant differences in TNM stage （χ2=7.85， P=0.005； χ2=6.32， P=0.012） and differentiation degree （χ2=11.59， P=0.001； χ2=9.92， P=0.002） between patients with high and low level of miR-24-3p and H2AFX. Compared with the non-relapsed patients， the serum miR-24-3p level was significantly lower （0.44±0.12 vs. 0.64±0.14） and the H2AFX level was significantly higher （1.87±0.42 vs. 1.38±0.33） among the relapsed patients， with statistically significant differences （t=7.79， P<0.001； t=6.79， P<0.001）. Univariate analysis showed that TNM stage （OR=1.57， 95%CI： 1.05-2.35， P=0.029）， differentiation degree （OR=2.20， 95%CI： 1.20-4.02， P=0.011）， miR-24-3p level （OR=0.66， 95%CI： 0.45-0.95， P=0.026）， H2AFX level （OR=1.73， 95%CI： 1.14-2.60， P=0.009） were all influential factors for postoperative recurrence in liver cancer patients. Multifactorial analysis showed that TNM stage （OR=2.10， 95%CI： 1.14-3.86， P=0.017）， differentiation degree （OR=1.58， 95%CI： 1.12-2.23， P=0.009）， miR-24-3p level （OR=0.76， 95%CI： 0.63-0.92， P=0.005）， H2AFX level （OR=1.90， 95%CI： 1.20-2.99， P=0.006） were the independent influencing factors of postoperative recurrence in liver cancer patients. Conclusion There are statistically significant differences in tumor TNM stage and differentiation degree among liver cancer patients with different serum miR-24-3p and H2AFX levels， and serum miR-24-3p and H2AFX levels are the influencing factors for postoperative recurrence in liver cancer patients. Figures and Tables | References | Related Articles | Metrics

Reviews

Role of PFDN and its subunits in tumorigenesis and tumor development Guo Zehao, Zhang Junwang 2024, 51 (6):  350-353.  doi: 10.3760/cma.j.cn371439-20240218-00060 Abstract ( 54 )   HTML ( 6 )   PDF (675KB) ( 38 )   Save Prefoldin （PFDN） acts as a co-companion protein to stabilize newly synthesized peptides and prevent protein misfolding and aggregation. PFDN plays an important role in cytoskeleton formation. PFDN is upregulated in glioma， breast cancer， lung cancer， gastric cancer， liver cancer， colorectal cancer and other tumor tissues and is closely linked with the proliferation and migration of tumor cells. A deeper understanding of the role of PFDN in tumorigenesis and development may provide new ideas and insights for PFDN in preventing or reversing tumor progression. References | Related Articles | Metrics

Advances in anti-tumor drugs with new mechanisms of action Zhang Baihong, Yue Hongyun 2024, 51 (6):  354-358.  doi: 10.3760/cma.j.cn371439-20240318-00061 Abstract ( 69 )   HTML ( 6 )   PDF (722KB) ( 31 )   Save Cytotoxic agents， molecular targeted agents and immune checkpoint inhibitors consist of the fundamental model of cancer systematic treatments. Anti-tumor drugs with new mechanisms of action， including kinase inhibitors， therapeutic antibodies， nucleic acid blocks， therapeutic vaccines， gene-edited immune cells， living microrobots and digital drugs， will change this existing model. Drugs targrting nerves， polysaccharides， lipids and microflora may gradually enter clinical applications. References | Related Articles | Metrics

Research progress of EBV in tumor immune microenvironment and immunotherapy of nasopharyngeal carcinoma Xu Fenglin, Wu Gang 2024, 51 (6):  359-363.  doi: 10.3760/cma.j.cn371439-20240119-00062 Abstract ( 135 )   HTML ( 8 )   PDF (698KB) ( 35 )   Save Nasopharyngeal carcinoma is a type of cancer closely related to Epstein-Barr virus （EBV） infection and is accompanied by high-level immune cell infiltration around the cancer nest. There are two immune cells with opposite functions in the tumor immune microenvironment （TIME） of EBV-positive nasopharyngeal carcinoma. However， due to the effects of EBV surface membrane proteins and interferon-γ and the high expression of programmed death receptor-1， TIME behaves as immunosuppressive effects. Immunotherapy utilizes the immunosuppressive properties of TIME to alter the level of immune response， thereby inhibiting the progression of nasopharyngeal cancer. Immunotherapy methods for EBV-related nasopharyngeal carcinoma include immune checkpoint inhibitors， cellular immunotherapy， tumor vaccines and oncolytic virus immunotherapy. Further exploration of the relationship between EBV and TIME and the role of EBV in the immunotherapy strategy for nasopharyngeal carcinoma can provide a basis for precise immunotherapy of EBV-positive nasopharyngeal carcinoma. References | Related Articles | Metrics

Advances of antibody-drug conjugate in the therapy of metastatic breast cancer Wang Ying, Liu Nan, Guo Bing 2024, 51 (6):  364-369.  doi: 10.3760/cma.j.cn371439-20231130-00063 Abstract ( 55 )   HTML ( 7 )   PDF (746KB) ( 17 )   Save Antibody-drug conjugate （ADC） couplings enable precise tumor targeted chemotherapy by combining cytotoxic drugs with antibodies against tumor cell targets via a linker. Trastuzumab emtansine and trastuzumab deruxtecan targeting human epidermal growth factor receptor （HER）2 are effective and have been approved as the standard second-line treatment for HER2-positive metastatic breast cancer. Sacituzumab govitecan targeting trophoblast cell surface antigen-2 has achieved remarkable efficacy in the treatment of metastatic triple-negative breast cancer. Other ADC that targeting Nectin-4， mesothelin， LIV-1， receptor tyrosine kinase-like orphan receptor， HER3， and other targets have reasonable efficacy and broad prospects. Further discussion on the research progress of ADC in the treatment of metastatic breast cancer can provide ideas for the application and development of ADC. References | Related Articles | Metrics

Research progress of colorectal cancer risk assessment models based on FIT and gut microbiota Zhang Rui, Chu Yanliu 2024, 51 (6):  370-375.  doi: 10.3760/cma.j.cn371439-20231213-00064 Abstract ( 46 )   HTML ( 2 )   PDF (703KB) ( 7 )   Save Colorectal cancer risk assessment model is an important method to identify high-risk groups of colorectal cancer in colorectal cancer screening. In recent years， fecal immunochemical test （FIT） and gut microbiota have become research hotspots. Domestic and foreign scholars have established a variety of colorectal cancer risk assessment models based on FIT and gut microbiota， including colorectal cancer risk assessment models based on FIT， colorectal cancer risk assessment models based on gut microbiota， and colorectal cancer risk assessment models based on FIT and gut microbiota. The above assessment models are helpful for colorectal cancer screening and early diagnosis and treatment. Among the existing assessment models， the FIT combined with gut microbiota assessment model has shown a high diagnostic efficiency for colorectal cancer， which is expected to become a valuable non-invasive screening method for colorectal cancer. References | Related Articles | Metrics

Research progress on intestinal flora and non-surgical treatment of the colorectal cancer Gao Fan, Wang Ping, Du Chao, Chu Yanliu 2024, 51 (6):  376-381.  doi: 10.3760/cma.j.cn371439-20240429-00065 Abstract ( 145 )   HTML ( 5 )   PDF (744KB) ( 39 )   Save In recent years， intestinal flora has gradually become the focus of research on the treatment of malignant neoplasms. Intestinal opportunistic pathogens （such as Fusobacterium nucleatum， Bacteroides fragilis）， intestinal probiotics （such as Clostridium butyricum， Lactic acid bacteria） and intestinal pathogenic bacteria （such as Salmonella， Shigella） can affect the efficacy and related adverse reactions of radiotherapy， chemotherapy and immunotherapy for the colorectal cancer （CRC） by influencing signaling pathways， modulating autophagy， regulating immune response， producing metabolites and toxins， and transplanting fecal bacteria. At the same time， it provides a large number of potential targets for targeted therapy of the CRC. Further research on the relationship between intestinal flora and non-surgical treatment of the CRC can provide references for basic and clinical research of non-surgical treatment of the CRC. References | Related Articles | Metrics