Szylberg Łukasz, Janiczek Marlena, Popiel Aneta, Marszałek Andrzej
Department of Clinical Pathomorphology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.
Department of Oncological Pathology, Poznan University of Medical Sciences and Greater Poland Oncology Center, Poland.
Adv Clin Exp Med. 2015 Jul-Aug;24(4):555-63. doi: 10.17219/acem/31239.
Colorectal cancer (CRC) has become the third most common cancer in developed countries. Each year more and more people die from CRC. CRC is also one of the most effectively studied topics in recent years. It has been found that the key phenomena in CRC development are genetic and inflammatory processes. Well-known genetic bases for the carcinogenesis of CRC include chromosomal changes characteristic of the chromosomal instability pathway which correlates with specific and well-defined genetic alterations (such as APC, K-RAS, DCC and p53) and genomic instability characteristics for the mutator pathway focused on KRAS and BRAF mutations. Recent studies have highlighted the impact of inflammation in CRC, especially elevated levels of pro-inflammatory cytokines. Among important risk factors of colon carcinogenesis are colorectal polyps, which are currently the subject of intense research. Recent studies have shown that different adenomas are characterized by different pathways of carcinogenesis as well as diverse COX-2 expression in various polyps. Understanding the mechanism of inflammatory processes in CRC parallel to basic genetic alterations might allow for effective and targeted treatment.
结直肠癌（CRC）已成为发达国家中第三大常见癌症。每年都有越来越多的人死于结直肠癌。结直肠癌也是近年来研究最为深入的课题之一。现已发现，结直肠癌发展过程中的关键现象是遗传和炎症过程。结直肠癌致癌作用的著名遗传基础包括染色体不稳定途径所特有的染色体变化，这与特定且明确的基因改变（如APC、K-RAS、DCC和p53）相关，以及专注于KRAS和BRAF突变的突变途径的基因组不稳定特征。最近的研究突出了炎症在结直肠癌中的影响，尤其是促炎细胞因子水平的升高。结肠致癌的重要风险因素之一是结直肠息肉，目前它是深入研究的对象。最近的研究表明，不同的腺瘤具有不同的致癌途径以及各种息肉中不同的COX-2表达。了解与基本基因改变并行的结直肠癌炎症过程机制可能有助于实现有效且有针对性的治疗。
