Cheah Peh Yean
Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore.
Crit Rev Oncol Hematol. 2009 Jan;69(1):45-55. doi: 10.1016/j.critrevonc.2008.08.001. Epub 2008 Sep 6.
Colorectal cancer (CRC) is one of the most prevalent cancers and leading cause of cancer mortality worldwide. It is also one of the most curable cancers if detected early. This review classifies the diverse disease subtypes using various parameters including phenotypes of the polyps and describes how recent advances in genetics have impacted on disease diagnostics. For familial syndromes, the discovery of initiating mutations in the germline made personalized medicine a reality. A model linking the main tumorigenesis (Wnt/TGF-beta-BMP/LKB-1/PI3K-AKT) pathways and a strategy for gene testing are proposed. For sporadic CRC, high throughput technology has enabled the discovery of susceptibility loci that increased CRC risk. The ramifications of screening the population for susceptibility loci are discussed.
结直肠癌(CRC)是全球最常见的癌症之一,也是癌症死亡的主要原因。如果早期发现,它也是最可治愈的癌症之一。本综述使用包括息肉表型在内的各种参数对不同的疾病亚型进行分类,并描述遗传学的最新进展如何影响疾病诊断。对于家族性综合征,种系中起始突变的发现使个性化医疗成为现实。提出了一个连接主要肿瘤发生(Wnt/TGF-β-BMP/LKB-1/PI3K-AKT)途径的模型和一种基因检测策略。对于散发性CRC,高通量技术已使发现增加CRC风险的易感位点成为可能。讨论了对人群进行易感位点筛查的影响。