Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB, Canada.
Dig Dis Sci. 2014 Oct;59(10):2390-402. doi: 10.1007/s10620-014-3210-7. Epub 2014 May 20.
Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in North America. Screening for CRC and its precursor lesions is highly effective in reducing the incidence and deaths due to the disease. However, there remain a substantial number of individuals who are diagnosed with CRC soon after a negative/clearing colonoscopy with no documented evidence of CRC. The occurrence of these interval CRCs (I-CRCs) reduces the effectiveness of CRC screening and detection tests and has only recently attracted wide spread attention. I-CRCs can be subdivided into those that occur most likely due to the failure of the colonoscopy examination (missed CRC and CRC that developed from missed or incompletely resected precursor lesions) and those that develop rapidly after the colonoscopy (de novo I-CRCs). In this review, we discuss the current literature and present both the clinical and biological factors that have been identified to account for I-CRCs, with a particular focus on the aberrant molecular features that are candidate causative agents for I-CRCs. We conclude additional studies are required to fully understand the molecular features that lead to the development of I-CRCs, which in turn is essential to develop measures to prevent the occurrence of this group of CRCs and thereby improve CRC screening and detection strategies.
结直肠癌（CRC）仍然是北美癌症相关死亡的第二大主要原因。CRC 及其前体病变的筛查在降低疾病发病率和死亡率方面非常有效。然而，仍有相当数量的个体在阴性/清除结肠镜检查后不久被诊断出 CRC，且没有 CRC 的明确证据。这些间隔期 CRC（I-CRC）的发生降低了 CRC 筛查和检测试验的效果，直到最近才引起广泛关注。I-CRC 可细分为那些最有可能因结肠镜检查失败而发生的（漏检 CRC 和由漏检或未完全切除的前体病变发展而来的 CRC）和那些在结肠镜检查后迅速发生的（新发性 I-CRC）。在这篇综述中，我们讨论了目前的文献，并介绍了已确定的导致 I-CRC 的临床和生物学因素，特别关注可能导致 I-CRC 的异常分子特征。我们得出结论，需要进一步的研究来充分了解导致 I-CRC 发展的分子特征，这对于制定预防这组 CRC 发生的措施以及改进 CRC 筛查和检测策略至关重要。
