引用文本：万欣怡, 司徒颖婷, 张炜力, 等. 错配修复完整/微卫星稳定型结直肠癌肝转移免疫治疗研究进展[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(1): 28-37.

作者：万欣怡¹，司徒颖婷²，张炜力²，王若蔚²，王炜锋²，周驰²，李伟豪²，林俊忠²，彭健宏²

单位：1. 中山大学医学院，广东 深圳 518107；2. 中山大学肿瘤防治中心 结直肠科，华南恶性肿瘤防治全国重点实验室，广东省恶性肿瘤临床医学研究中心，广东 广州 510060

Authors：Wan Xinyi¹, Situ Yingting², Zhang Weili², Wang Ruowei², Wang Weifeng², Zhou Chi², Li Weihao², Lin Junzhong², Peng Jianhong²

Unit：1. School of Medicine, Sun Yat-sen University, Shenzhen 518107, Guangdong, China；2. Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Clinical Research Center for Cancer, Guangzhou 510060, Guangdong, China

摘要：

对于绝大多数错配修复完整（proficient mismatch repair, pMMR）/微卫星稳定（microsatellite stability, MSS）型结直肠癌肝转移（colorectal cancer liver metastases, CRLM）患者而言，肝脏所特有的免疫抑制微环境是导致其对免疫检查点抑制剂（immune checkpoint inhibitor, ICI）耐药的主要原因。本文系统梳理了pMMR/MSS型CRLM免疫治疗的最新研究进展。尽管ICI单药疗效有限，但其与化学治疗、靶向治疗或局部治疗相结合的联合策略在CRLM一线治疗中已展现出良好的临床疗效；而在后线治疗中，该类策略对CRLM患者的临床疗效仍不理想。有效的生物标志物有助于精准筛选可能从免疫治疗中获益的优势人群，是实现个体化治疗的关键。未来研究的重点在于发展多模式、多机制的联合治疗策略，以有效逆转肝脏免疫抑制微环境，改善免疫治疗疗效。

关键词：结直肠癌肝转移；联合治疗；免疫抑制；生物标志物

Abstract：

For the majority of patients with colorectal cancer liver metastases (CRLM) who have proficient mismatch repair (pMMR)/microsatellite stability (MSS), the unique immunosuppressive microenvironment of the liver is the main reason for their resistance to immune checkpoint inhibitor (ICI). This article systematically reviews the latest research progress in immunotherapy for pMMR/MSS-type CRLM. Although the efficacy of ICI alone is limited, the combination strategies of ICI with chemotherapy, targeted therapy, or local treatment approaches have demonstrated good clinical efficacy in the first-line treatment of CRLM. However, in the later lines of treatment, the efficacy of these strategies for CRLM patients is still not satisfactory. Effective biomarkers can help precisely screen out the potential beneficiaries who may benefit from immunotherapy, which is the key to achieving individualized treatment. Future research should focus on developing multi-modal, multi-mechanism combination therapy strategies to effectively reverse the immunosuppressive microenvironment of the liver and enhance the efficacy of immunotherapy.

Key words：Colorectal cancer liver metastases；Combination therapy；Immunosuppression；Biomarker

注：网络优先发布