Wright Moriah, Beaty Jenifer S, Ternent Charles A
Colon and Rectal Surgery, Inc, 9850 Nicholas Street, Suite 100, Omaha, NE 68114, USA.
Department of Surgery, CHI Creighton University Medical Center Bergan Mercy, 7500 Mercy Road, Omaha, NE 68124, USA; Department of Surgery, University of Nebraska Medical Center, S 42nd Street and Emile Street, Omaha, NE 68198, USA.
Surg Clin North Am. 2017 Jun;97(3):683-701. doi: 10.1016/j.suc.2017.01.014.
Colorectal cancers develop through at least 3 major pathways, including chromosomal instability, mismatch repair, and methylator phenotype. These pathways can coexist in a single individual and occur in both sporadic and inherited colorectal cancers. In spite of the unique molecular and genetic signatures of colorectal cancers, nonspecific chemotherapy based on the antineoplastic effects of 5-fluorouracil is the cornerstone of therapy for stage III and some stage II disease. Techniques to recognize colorectal cancer at the molecular level have facilitated development of new signature drugs designed to inhibit the unique pathways of colorectal cancer growth and immunity.
结直肠癌至少通过3条主要途径发展,包括染色体不稳定、错配修复和甲基化表型。这些途径可在同一个体中共存,且在散发性和遗传性结直肠癌中均会出现。尽管结直肠癌具有独特的分子和基因特征,但基于5-氟尿嘧啶抗肿瘤作用的非特异性化疗仍是III期及部分II期疾病治疗的基石。在分子水平识别结直肠癌的技术推动了旨在抑制结直肠癌生长和免疫独特途径的新型靶向药物的研发。