干细胞在维持肠道稳态、协调再生以及结直肠癌（CRC）发生和进展的关键步骤中发挥着关键作用。有趣的是，成体干细胞在许多这些过程中都会减少。相反，在发育过程中常见的原始胎儿程序在组织修复、结直肠癌转移和治疗抵抗过程中出现。最近的研究结果表明成人和胎儿干细胞计划之间存在动态连续体。我们讨论了促进干细胞状态之间可塑性的关键机制，并强调了在胎儿样状态出现时观察到的异质性。我们专注于通过靶向胎儿样​​ CRC 细胞而产生的治疗机会，以及如何将这些概念转化为临床。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Stem cells play pivotal roles in maintaining intestinal homeostasis, orchestrating regeneration, and in key steps of colorectal cancer (CRC) initiation and progression. Intriguingly, adult stem cells are reduced during many of these processes. On the contrary, primitive fetal programs, commonly detected in development, emerge during tissue repair, CRC metastasis, and therapy resistance. Recent findings indicate a dynamic continuum between adult and fetal stem cell programs. We discuss critical mechanisms facilitating the plasticity between stem cell states and highlight the heterogeneity observed upon the appearance of fetal-like states. We focus on therapeutic opportunities that arise by targeting fetal-like CRC cells and how those concepts can be translated into the clinic.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.