Department of Pathology and Laboratory Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8.
Gastroenterol Res Pract. 2012;2012:184343. doi: 10.1155/2012/184343. Epub 2011 Nov 17.
Despite multiple screening techniques, including colonoscopy, flexible sigmoidoscopy, radiological imaging, and fecal occult blood testing, colorectal cancer remains a leading cause of death. As these techniques improve, their sensitivity to detect malignant lesions is increasing; however, detection of precursor lesions remains problematic and has generated a lack of general acceptance for their widespread usage. Early detection by an accurate, noninvasive, cost-effective, simple-to-use screening technique is central to decreasing the incidence and mortality of this disease. Recent advances in the development of molecular markers in faecal specimens are encouraging for its use as a screening tool. Genetic mutations and epigenetic alterations that result from the carcinogenetic process can be detected by coprocytobiology in the colonocytes exfoliated from the lesion into the fecal matter. These markers have shown promising sensitivity and specificity in the detection of both malignant and premalignant lesions and are gaining popularity as a noninvasive technique that is representative of the entire colon. In this paper, we summarize the genetic and epigenetic fecal molecular markers that have been identified as potential targets in the screening of colorectal cancer.
尽管有多种筛查技术，包括结肠镜检查、乙状结肠镜检查、影像学检查和粪便潜血检测，但结直肠癌仍然是导致死亡的主要原因。随着这些技术的不断改进，它们对恶性病变的检测灵敏度也在不断提高；然而，对癌前病变的检测仍然存在问题，并且对其广泛应用的接受程度不高。通过准确、无创、具有成本效益、易于使用的筛查技术进行早期检测，对于降低这种疾病的发病率和死亡率至关重要。最近在粪便标本中分子标志物的开发方面取得了进展，这为将其用作筛查工具带来了希望。通过对从病变脱落到粪便中的结肠细胞进行粪便细胞化学分析，可以检测到致癌过程中产生的遗传突变和表观遗传改变。这些标志物在检测恶性和癌前病变方面显示出了有希望的灵敏度和特异性，并且作为一种能够代表整个结肠的非侵入性技术越来越受欢迎。本文总结了在结直肠癌筛查中已被确定为潜在靶点的遗传和表观遗传粪便分子标志物。
