Colorectal cancer liver metastasis (CRLM) is a highly heterogeneous disease. Therapies that target both primary foci and liver metastasis are severely lacking. Therefore, understanding the features of metastatic tumor cells in the liver is valuable for the overall control of CRLM patients. In this review, we summarize the heterogeneity exhibited in CRLM from five aspects (gene, transcriptome, protein, metabolism, and immunity). In addition to genetic heterogeneity, the other four aspects exhibit significant heterogeneity. Compared to primary CRC, the dysregulation of epithelial–mesenchymal transition (EMT)-related proteins, the enhanced metabolic activity, and the increased infiltration of immunosuppressive cells are detected in CRLM. Preclinical evidence shows that targeting the EMT process or enhancing cellular metabolism may represent a novel approach to increasing the therapeutic efficacy of CRLM.
结直肠癌肝转移（CRLM）是一种高度异质性的疾病。目前针对原发灶和肝转移灶的双重靶向治疗手段严重不足。因此，理解肝转移肿瘤细胞的特征对于全面控制CRLM患者的病情具有重要意义。本综述从基因、转录组、蛋白质、代谢和免疫五个方面总结了CRLM表现出的异质性。除遗传异质性外，其他四个方面均表现出显著的异质性。与原发性结直肠癌相比，CRLM中上皮-间质转化（EMT）相关蛋白表达失调、代谢活性增强、免疫抑制细胞浸润增加。临床前证据表明，靶向EMT过程或增强细胞代谢可能成为提高CRLM治疗效果的新策略。
Multilevel Heterogeneity of Colorectal Cancer Liver Metastasis
肿瘤(癌症)患者之家