Yiu Andrew J, Yiu Chu Y
Guy's, King's and St. Thomas' School of Medical Education, King's College London, London, U.K.
Department of Surgery, Queen Elizabeth Hospital, London, U.K.
Anticancer Res. 2016 Mar;36(3):1093-102.
Colorectal cancer is the third most common cancer worldwide, with 1.36 million people diagnosed in 2012. The prognosis of colorectal cancer is better with an earlier diagnosis. The outcome of colorectal cancer may also be improved by targeting pathways involved in colorectal cancer formation, such as anti-epidermal growth factor receptor (EGFR) therapy. An understanding of colorectal carcinogenesis is essential for the design of molecular targeting. Recent advances in the molecular subtypes of colorectal cancer, methylation of DNA in colorectal cancer, and micro-RNA biogenesis, and their involvement in colorectal cancer have resulted in the identification of many new colorectal biomarkers. Such biomarkers may be used for earlier diagnosis of, selection of 'personalised' therapy for, and prognosis of colorectal cancer. Many of these biomarkers appear promising in small-scale studies. However, validation of their effectiveness with large-scale clinical trials is needed before routine clinical application. To this end, the recently established consensus molecular subtypes of colorectal cancer would enable like-for-like comparisons of the treatment outcomes of clinical trials.
结直肠癌是全球第三大常见癌症，2012年有136万人被诊断出患有该病。结直肠癌早期诊断时预后较好。通过靶向参与结直肠癌形成的途径，如抗表皮生长因子受体（EGFR）治疗，也可改善结直肠癌的治疗结果。了解结直肠癌的致癌机制对于分子靶向治疗的设计至关重要。结直肠癌分子亚型、结直肠癌中DNA甲基化以及微小RNA生物合成方面的最新进展，以及它们在结直肠癌中的作用，已导致鉴定出许多新的结直肠癌生物标志物。此类生物标志物可用于结直肠癌的早期诊断、“个性化”治疗选择及预后评估。其中许多生物标志物在小规模研究中显示出前景。然而，在常规临床应用之前，需要通过大规模临床试验验证其有效性。为此，最近建立的结直肠癌共识分子亚型将使临床试验的治疗结果能够进行同类比较。
