多种分子机制促进结直肠癌（CRC）的发展，其中染色体不稳定性（CIN）起着重要作用。CRC受到多个重要基因突变的影响，包括APC、TP53、KRAS、PIK3CA、BRAF和SMYD4。该疾病的三个分子亚型是CIN、MSI-H和CIMP（CpG岛表型）。p53功能失调和异常的Wnt信号传导是CRC癌变的共同特点。尽管传统治疗取得了进展，但转移性CRC由于毒性和耐药性而难以治疗。纳米技术对癌症的治疗诊断联合疗法（Theranostics）具有重要意义，因为它能够实现更有针对性、个体化护理，并减少副作用。利用功能化纳米颗粒实现了MRI引导的基因治疗、磁性热疗、化疗、免疫疗法以及光热/光动力疗法，从而彻底改变了癌症的治疗方式。使用纳米颗粒上的配体或肽段的主动靶向改善了药物传递到癌细胞的效果。药物肽共轭物、壳聚糖纳米颗粒、金纳米颗粒、碳纳米管、介孔二氧化硅基纳米颗粒、银纳米颗粒、混合脂质聚合物纳米颗粒、氧化铁纳米颗粒和量子点等纳米结构可能实现对CRC的靶向药物传递和增强治疗效果。纳米药物目前正在临床试验中评估用于结直肠癌的治疗，有望提供更有效和个体化的治疗方案。本文考察了CRC的当前纳米医学专利，包括Delta-Fly、Merrimack和Pfenning, Meaning & Partner等的工作。从未来纳米医学研究和发展的角度来看，配体生产、颗粒大小和清除是重要因素。最后，纳米医学用于靶向药物治疗和诊断的众多纳米结构表明了改善CRC治疗前景的乐观前景。本综述还强调了现有结肠癌治疗的纳米医学研究和发展的成功之处。© 2023。本文作者授予Springer-Verlag GmbH Germany独家许可使用，隶属于Springer Nature。

Multiple molecular mechanisms contribute to the development of colorectal cancer (CRC), with chromosomal instability (CIN) playing a significant role. CRC is influenced by mutations in several important genes, including APC, TP53, KRAS, PIK3CA, BRAF, and SMYD4. The three molecular subtypes of this disease are CIN, MSI-H, and CIMP (CpG-island phenotype). p53 dysfunction and aberrant Wnt signalling are common characteristics of CRC carcinogenesis. Despite advances in conventional therapy, metastatic CRC remains difficult to treat due to toxicity and resistance. Theranostics for cancer could significantly benefit from nanotechnology, as it would enable more targeted, individualised care with fewer side effects. Utilising functionalized nanoparticles has enabled MRI-guided gene therapy, magnetic hyperthermia, chemotherapy, immunotherapy, and photothermal/photodynamic therapy, thereby radically modifying the way cancer is treated. Active targeting using ligands or peptides on nanoparticles improves the delivery of drugs to cancer cells. Nanostructures such as drug peptide conjugates, chitosan nanoparticles, gold nanoparticles, carbon nanotubes, mesoporous silica-based nanoparticles, silver nanoparticles, hybrid lipid-polymer nanoparticles, iron oxide nanoparticles, and quantum dots may enable targeted drug delivery and enhanced therapeutic efficacy against CRC. Nanomedicines are presently being evaluated in clinical trials for the treatment of colorectal cancer, with the promise of more effective and individualised therapies. This article examines current nanomedicine patents for CRC, including the work of Delta-Fly, Merrimack, and Pfenning, Meaning & Partner, among others. In terms of future nanomedicine research and development, ligand production, particle size, and clearance are crucial factors. Lastly, the numerous nanostructures utilized in nanomedicine for targeted drug administration and diagnostics indicate optimistic prospects for enhancing CRC treatment. The successes of nanomedicine research and development for existing colon cancer treatments are also highlighted in this review.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.