Martin L, Assem M, Piard F
Laboratoire d'anatomopathologie, Faculté de Médecine, Dijon, France.
Eur J Cancer Prev. 1999 Dec;8 Suppl 1:S13-20.
Molecular studies have shown that different genetic pathways are involved in the history of colorectal carcinomas. This suggests that a correlation exists between the molecular, clinical and pathological features of tumours. Two large groups can be individualized: the first group is characterized by allelic losses and hyperdiploidy. These LOH (for loss of heterozygosity)-positive tumours represent 80% of colorectal carcinomas. Among them more than two-thirds are located in the distal colon. They have the worst prognosis. The second group has a normal diploid pattern and a phenotypic microsatellite instability without allelic losses. These tumours represent 10-15% of all colorectal carcinomas and about 30% of the right-sided tumours. They are associated with a better prognosis. In the future, it would perhaps be better to classify colorectal carcinomas according to their molecular features rather than to their topographical localizations.
分子研究表明，不同的遗传途径参与了结直肠癌的发生发展过程。这表明肿瘤的分子、临床和病理特征之间存在相关性。可以区分出两大类：第一类的特征是等位基因缺失和超二倍体。这些杂合性缺失（LOH）阳性肿瘤占结直肠癌的80%。其中超过三分之二位于结肠远端。它们的预后最差。第二类具有正常的二倍体模式和表型微卫星不稳定性，且无等位基因缺失。这些肿瘤占所有结直肠癌的10 - 15%，约占右侧肿瘤的30%。它们的预后较好。未来，根据结直肠癌的分子特征而非其解剖学定位进行分类可能会更好。
