结直肠癌（CRC）仍然是全球癌症相关死亡的主要原因之一。其复杂性受到控制细胞增殖、存活、分化和凋亡的各种信号转导网络的影响。 CRC 的发病机制证明了这些信号级联的失调，最终导致结肠上皮的恶性转化。本综述旨在剖析结直肠癌中涉及的基本信号机制，以阐明支撑肿瘤进化和进展的一般原则。我们讨论了 CRC 的分子特征，包括 CRC 的基因组、表观基因组和微生物特征，以强调信号转导在致瘤过程中的作用。与此同时，我们回顾了结直肠癌靶向和免疫疗法的出现，评估了它们对当前临床格局的影响。这些疗法的发展得益于对致癌信号传导的深入了解，从而识别出这些网络中可药理学利用的关键节点。此外，我们探索了整合人工智能的潜力，以提高治疗目标和患者分层的精确度，强调它们在个性化医疗中的作用。总之，我们的综述捕捉到了 CRC 发病机制中的异常信号传导与通过靶向治疗策略来抵消这些变化的共同努力之间的动态相互作用，最终旨在为改善结直肠癌的预后和个性化治疗方式铺平道路。© 2024。作者（s）。

Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide. Its complexity is influenced by various signal transduction networks that govern cellular proliferation, survival, differentiation, and apoptosis. The pathogenesis of CRC is a testament to the dysregulation of these signaling cascades, which culminates in the malignant transformation of colonic epithelium. This review aims to dissect the foundational signaling mechanisms implicated in CRC, to elucidate the generalized principles underpinning neoplastic evolution and progression. We discuss the molecular hallmarks of CRC, including the genomic, epigenomic and microbial features of CRC to highlight the role of signal transduction in the orchestration of the tumorigenic process. Concurrently, we review the advent of targeted and immune therapies in CRC, assessing their impact on the current clinical landscape. The development of these therapies has been informed by a deepening understanding of oncogenic signaling, leading to the identification of key nodes within these networks that can be exploited pharmacologically. Furthermore, we explore the potential of integrating AI to enhance the precision of therapeutic targeting and patient stratification, emphasizing their role in personalized medicine. In summary, our review captures the dynamic interplay between aberrant signaling in CRC pathogenesis and the concerted efforts to counteract these changes through targeted therapeutic strategies, ultimately aiming to pave the way for improved prognosis and personalized treatment modalities in colorectal cancer.© 2024. The Author(s).