Tsang Andy Hin-Fung, Cheng Ka-Ho, Wong Apple Siu-Ping, Ng Simon Siu-Man, Ma Brigette Buig-Yue, Chan Charles Ming-Lok, Tsui Nancy Bo-Yin, Chan Lawrence Wing-Chi, Yung Benjamin Yat-Ming, Wong Sze-Chuen Cesar
Andy Hin-Fung Tsang, Ka-Ho Cheng, Apple Siu-Ping Wong, Nancy Bo-Yin Tsui, Lawrence Wing-Chi Chan, Benjamin Yat-Ming Yung, Sze-Chuen Cesar Wong, Department of Health Technology and Informatics, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China.
World J Gastroenterol. 2014 Apr 14;20(14):3847-57. doi: 10.3748/wjg.v20.i14.3847.
Colorectal cancer (CRC) is one of the most prevalent cancers in developed countries. On the other hand, CRC is also one of the most curable cancers if it is detected in early stages through regular colonoscopy or sigmoidoscopy. Since CRC develops slowly from precancerous lesions, early detection can reduce both the incidence and mortality of the disease. Fecal occult blood test is a widely used non-invasive screening tool for CRC. Although fecal occult blood test is simple and cost-effective in screening CRC, there is room for improvement in terms of the accuracy of the test. Genetic dysregulations have been found to play an important role in CRC development. With better understanding of the molecular basis of CRC, there is a growing expectation on the development of diagnostic tests based on more sensitive and specific molecular markers and those tests may provide a breakthrough to the limitations of current screening tests for CRC. In this review, the molecular basis of CRC development, the characteristics and applications of different non-invasive molecular biomarkers, as well as the technologies available for the detection were discussed. This review intended to provide a summary on the current and future molecular diagnostics in CRC and its pre-malignant state, colorectal adenoma.
结直肠癌(CRC)是发达国家中最常见的癌症之一。另一方面,如果通过定期结肠镜检查或乙状结肠镜检查在早期阶段发现,CRC也是最可治愈的癌症之一。由于CRC从癌前病变缓慢发展而来,早期检测可以降低该疾病的发病率和死亡率。粪便潜血试验是一种广泛用于CRC的非侵入性筛查工具。尽管粪便潜血试验在筛查CRC方面简单且具有成本效益,但在检测准确性方面仍有改进空间。已发现基因失调在CRC发展中起重要作用。随着对CRC分子基础的更好理解,人们对基于更敏感和特异分子标志物的诊断测试的开发期望越来越高,这些测试可能会突破当前CRC筛查测试的局限性。在本综述中,讨论了CRC发展的分子基础、不同非侵入性分子生物标志物的特征和应用,以及可用于检测的技术。本综述旨在总结CRC及其癌前状态结肠腺瘤目前和未来的分子诊断。