Kasi Anup, Handa Shivani, Bhatti Sajjad, Umar Shahid, Bansal Ajay, Sun Weijing
Department of Medicine, Division of Medical Oncology, Kansas University Medical Center, Kansas City, KS, U.S.A.
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai West & Morningside, NY, NY.
Curr Colorectal Cancer Rep. 2020 Sep;16(5):97-106. doi: 10.1007/s11888-020-00458-z. Epub 2020 Aug 15.
Molecular pathways in colorectal carcinogenesis involve several complex genetic and epigenetic modulations that cause normal colonic mucosa to metamorphose into a benign polyp and subsequently into a malignant tumor. Our purpose is to recapitulate historical and recent genomic research in order to augment the understanding of colorectal cancer pathogenesis.
In 2015, the molecular classification for colorectal cancers was unified into one system with four distinct groups, also called as consensus molecular subtypes. This led to an enhanced understanding of molecular and immune signatures which has implications on predicting the clinical behavior as well as response to different therapeutic agents.
In this review, we expound on the current literature as well as draw on our own experience to present the important molecular pathogenesis pathways, key genetic mutations, differences in pathogenesis of left versus right sided tumors as well as the molecular classification of colorectal cancers.
结直肠癌发生过程中的分子途径涉及多种复杂的基因和表观遗传调控,这些调控使正常结肠黏膜转变为良性息肉,随后发展为恶性肿瘤。我们的目的是概括历史和近期的基因组研究,以加深对结直肠癌发病机制的理解。
2015年,结直肠癌的分子分类被统一为一个包含四个不同组别的系统,也称为共识分子亚型。这增进了对分子和免疫特征的理解,对预测临床行为以及对不同治疗药物的反应具有重要意义。
在本综述中,我们阐述了当前的文献,并借鉴我们自己的经验,介绍了重要的分子发病机制途径、关键基因突变、左右侧肿瘤发病机制的差异以及结直肠癌的分子分类。