用于结直肠癌诊断、预后和治疗的遗传和表观遗传生物标志物。

Genetic and epigenetic biomarkers for diagnosis, prognosis and treatment of colorectal cancer.

作者信息

Coppedè Fabio, Lopomo Angela, Spisni Roberto, Migliore Lucia

机构信息

Fabio Coppedè, Angela Lopomo, Lucia Migliore, Department of Translational Research and New Technologies in Medicine and Surgery, Division of Medical Genetics, University of Pisa, 56126 Pisa, Italy.

出版信息

World J Gastroenterol. 2014 Jan 28;20(4):943-56. doi: 10.3748/wjg.v20.i4.943.

Abstract

Colorectal cancer (CRC) is one of the most common cancer worldwide and results from the accumulation of mutations and epimutations in colonic mucosa cells ultimately leading to cell proliferation and metastasis. Unfortunately, CRC prognosis is still poor and the search of novel diagnostic and prognostic biomarkers is highly desired to prevent CRC-related deaths. The present article aims to summarize the most recent findings concerning the use of either genetic or epigenetic (mainly related to DNA methylation) biomarkers for CRC diagnosis, prognosis, and response to treatment. Recent large-scale DNA methylation studies suggest that CRC can be divided into several subtypes according to the frequency of DNA methylation and those of mutations in key CRC genes, and that this is reflected by different prognostic outcomes. Increasing evidence suggests that the analysis of DNA methylation in blood or fecal specimens could represent a valuable non-invasive diagnostic tool for CRC. Moreover, a broad spectrum of studies indicates that the inter-individual response to chemotherapeutic treatments depends on both epigenetic modifications and genetic mutations occurring in colorectal cancer cells, thereby opening the way for a personalized medicine. Overall, combining genetic and epigenetic data might represent the most promising tool for a proper diagnostic, prognostic and therapeutic approach.

摘要

结直肠癌(CRC)是全球最常见的癌症之一,由结肠黏膜细胞中的突变和表突变积累导致,最终引发细胞增殖和转移。不幸的是,CRC的预后仍然很差,因此迫切需要寻找新的诊断和预后生物标志物以预防与CRC相关的死亡。本文旨在总结关于使用遗传或表观遗传(主要与DNA甲基化相关)生物标志物进行CRC诊断、预后和治疗反应的最新研究结果。近期大规模的DNA甲基化研究表明,CRC可根据DNA甲基化频率和关键CRC基因的突变频率分为几种亚型,且这反映在不同的预后结果中。越来越多的证据表明,分析血液或粪便样本中的DNA甲基化可能是一种有价值的CRC非侵入性诊断工具。此外,广泛的研究表明,个体对化疗治疗的反应取决于结肠癌细胞中发生的表观遗传修饰和基因突变,从而为个性化医疗开辟了道路。总体而言,结合遗传和表观遗传数据可能是进行正确诊断、预后和治疗的最有前景的工具。

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