[Progress in the evaluation of tumor response status after neoadjuvant therapy for rectal cancer].

In recent years,neoadjuvant therapy has become an integral part of the standard treatment for locally advanced rectal cancer.However,only approximately 15%-25% of patients achieve pathological complete response(pCR).With advances in tumor immunotherapy,treatment strategies targeting mismatch repair deficiency(dMMR) or microsatellite instability-high (MSI-H) status have demonstrated remarkable efficacy.Since the introduction of immunotherapy,either as monotherapy or in combination with chemoradiation,the pCR rate in dMMR or MSI-H rectal cancer patients has significantly improved,far surpassing that achieved with conventional neoadjuvant regimens.This enhancement in tumor regression has also facilitated the adoption of watch-and-wait(W&W)strategies.Accurate assessment of tumor response is essential for guiding individualized treatment plans.Consequently,more accurate evaluation methods are reqnired.This article comprehensively reviews recent advances in imaging,molecular biomarkers,endoscopic techniques,and multipoint full-layer puncture biopsy,offering a theoretical foundation and technical support for organ preservation strategies in the era of precision medicine.

近年来，新辅助治疗已成为局部进展期直肠癌标准治疗的重要组成部分，但仅有15%～25%的患者可达到病理完全缓解。随着肿瘤免疫治疗的深入，针对错配修复缺陷或微卫星高度不稳定亚型的治疗策略展现出显著疗效。自免疫治疗（单药或联合放化疗）应用以来，错配修复缺陷或微卫星高度不稳定亚型患者的病理完全缓解率显著提升，远超传统新辅助治疗。这不仅促进肿瘤的消退，也进一步推动了观察等待策略的应用。准确评估肿瘤缓解状态对制定个体化治疗策略至关重要，因此，需要更精准的评估手段。本文系统梳理了影像学、分子标记物、内镜及多点全层穿刺等技术的最新进展，为精准医学时代下器官保留策略提供理论依据和技术支撑。.