Sylvester Brooke E, Vakiani Efsevia
1 Human Oncology and Pathogenesis Program, 2 Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
J Gastrointest Oncol. 2015 Dec;6(6):668-75. doi: 10.3978/j.issn.2078-6891.2015.083.
Metastatic colorectal cancer (CRC) is one of the leading causes of cancer-related mortality among men and women worldwide. Over the past few decades, advances in our understanding of the genetic and epigenetic underpinnings of CRC have led to important insights into the pathogenesis of invasive tumors and have identified different molecular subgroups. Nonetheless, the events that might facilitate dissemination of tumor cells to distant sites giving rise to metastatic disease are not well characterized. Furthermore, in contrast to intertumor heterogeneity the extent of intratumor heterogeneity in different types of CRC has not been fully defined. In this paper, we review studies that have compared the genetic profile of primary invasive carcinomas to that of matched metastases and discuss the implications of their findings for our understanding of tumor evolution and for the clinical management of patients with advanced CRC.
转移性结直肠癌（CRC）是全球男性和女性癌症相关死亡的主要原因之一。在过去几十年中，我们对CRC的遗传和表观遗传基础的理解取得了进展，这为侵袭性肿瘤的发病机制提供了重要见解，并确定了不同的分子亚组。尽管如此，可能促进肿瘤细胞扩散到远处部位导致转移性疾病的事件尚未得到充分表征。此外，与肿瘤间异质性相反，不同类型CRC中肿瘤内异质性的程度尚未完全明确。在本文中，我们回顾了将原发性侵袭性癌的基因谱与匹配转移灶的基因谱进行比较的研究，并讨论了这些发现对我们理解肿瘤演变以及晚期CRC患者临床管理的意义。
