Cancer heterogeneity is a major challenge in oncology, complicating diagnosis, prognostication, and treatment. The clinical heterogeneity of cancer, which leads to differential treatment outcomes between patients with histopathologically similar cancers, is attributable to molecular diversity manifesting through genetic, epigenetic, transcriptomic, microenvironmental, and host biology differences. Heterogeneity is observed between patients, individual metastases, and within individual lesions. This review discusses clinical implications of heterogeneity, emphasizing need for personalized approaches to overcome challenges posed by cancer’s diverse presentations. Understanding of emerging molecular diagnostic and analytical techniques can provide a view into the multidimensional complexity of cancer heterogeneity. With over 90% of cancer-related deaths associated with metastasis, we additionally explore the role heterogeneity plays in treatment resistance and recurrence of metastatic lesions. Molecular insights from next-generation sequencing, single-cell transcriptomics, liquid biopsy technology, and artificial intelligence will facilitate the development of combination therapy regimens that can potentially induce lasting and even curative treatment outcomes.
癌症异质性是肿瘤学领域的一项重大挑战，其使诊断、预后判断及治疗过程复杂化。癌症的临床异质性导致组织病理学特征相似的癌症患者出现差异化的治疗结果，这种异质性源于通过遗传、表观遗传、转录组、微环境及宿主生物学差异所呈现的分子多样性。异质性不仅存在于不同患者之间，也体现在个体转移灶之间以及单个病灶内部。本综述探讨了异质性的临床意义，强调需要采用个体化策略来应对癌症多样化表现带来的挑战。对新兴分子诊断与分析技术的理解，有助于揭示癌症异质性的多维复杂性。鉴于超过90%的癌症相关死亡与转移相关，我们进一步探讨了异质性在转移病灶治疗抵抗与复发中的作用。基于新一代测序技术、单细胞转录组学、液体活检技术及人工智能获得的分子层面认知，将推动联合治疗方案的发展，这些方案有望实现持久甚至治愈性的治疗效果。
肿瘤(癌症)患者之家