远处转移仍然是结肠癌（CRC）患者死亡的主要原因。器官恶性趋势是指转移恶性对特定器官的倾向性，已在CRC中得到充分证明，其中肝脏、肺部和腹膜是首选地点。在建立宿主器官内的前转移巢穴之前，CRC细胞会分泌促进转移器官恶性趋势的物质。鉴于器官恶性趋向在CRC转移中的关键作用，全面了解其分子基础对于基于生物标志物的诊断、创新治疗开发和最终改善患者预后至关重要。在本综述中，我们着重介绍代谢重编程、肿瘤衍生外泌体、免疫系统和癌细胞与器官的相互作用，以概述CRC器官恶性转移的分子机制。此外，我们考虑了针对CRC治疗的转移器官恶性趋势靶向治疗的前景。© 2023年。BioMed Central Ltd.，施普林格自然出版集团的一部分。

Distant metastasis remains a leading cause of mortality among patients with colorectal cancer (CRC). Organotropism, referring to the propensity of metastasis to target specific organs, is a well-documented phenomenon in CRC, with the liver, lungs, and peritoneum being preferred sites. Prior to establishing premetastatic niches within host organs, CRC cells secrete substances that promote metastatic organotropism. Given the pivotal role of organotropism in CRC metastasis, a comprehensive understanding of its molecular underpinnings is crucial for biomarker-based diagnosis, innovative treatment development, and ultimately, improved patient outcomes. In this review, we focus on metabolic reprogramming, tumor-derived exosomes, the immune system, and cancer cell-organ interactions to outline the molecular mechanisms of CRC organotropic metastasis. Furthermore, we consider the prospect of targeting metastatic organotropism for CRC therapy.© 2023. BioMed Central Ltd., part of Springer Nature.