Stage Ⅱ (T3-4N0M0) accounts for 25% of colorectal cancer and five-year survival is between 70% and 80%. However, 25% of patients develop distant metastases and have a survival rate similar to that of stage Ⅲ disease. However, whether or not to give adjuvant chemotherapy is still a controversial issue. As a result, there has been a lot of interest in the identification of the pathological factors underlying the poor prognosis associated with this stage, in order to establish a firmer basis for the administration of adjuvant chemotherapy. But not all high-risk factors are equal for stage Ⅱ colorectal cancer, variability still exists in the management and outcomes of high-risk patients. Here be introduced and commented on thinking and understanding about its controversy and evolution for the attention of the working pathologist and gastroenterologist doctors.
Ⅱ期（T3-4N0M0）结直肠癌约占结直肠癌的30%，5年生存率在70%~80%。然而，约25%的患者出现远处转移，其生存率与Ⅲ期患者相似。辅助化疗是否会降低预后不良患者的复发风险仍不清楚，患者是否能从术后辅助治疗中获益尚存在争议。因此，人们对识别与该阶段相关的不良预后的病理因素非常感兴趣，以便为辅助化疗治疗奠定更坚实的基础。但并非所有高危因素的预后重要性都是同等的，不同高危患者的治疗和结果仍存在差异，而且对高危Ⅱ期结直肠癌患者的定义也在不断演变，该文将对其的理解和思考予以介绍和评述，希望引起临床和病理医师的关注。.