对有患结直肠癌高风险患者的癌前病变进行化学预防(综述)

Chemoprophylaxis of precancerous lesions in patients who are at a high risk of developing colorectal cancer (Review).

作者信息

Ogurchenok Nonna E, Khalin Konstantin D, Bryukhovetskiy Igor S

机构信息

Far Eastern Federal University, School of Medicine and Life Sciences, FEFU Medical Center, Russky Island, 690091 Vladivostok, Russian Federation.

Primorskiy Regional Clinical Hospital N1, Medical Center, Russky Island, 690091 Vladivostok, Russian Federation.

出版信息

Med Int (Lond). 2024 Mar 27;4(3):25. doi: 10.3892/mi.2024.149. eCollection 2024 May-Jun.

Abstract

The diagnostics of colorectal cancer (CRC) and precancerous lesions in the colon is one of the most urgent matters to be considered for the modern protocols of complex examination, recommended for use from the age of 45 years, and including both instrumental and laboratory methods of research: Colonoscopy, CT colonography, flexible sigmoidoscopy, fecal occult blood test, fecal immunohistochemistry test and stool DNA test Nevertheless, the removal of those precancerous lesions does not solve the issue, and, apart from the regular endoscopic monitoring of patients who are at a high risk of developing CRC, the pharmacological treatment of certain key pathogenic mechanisms leading to the development of CRC is required. The present review to discusses the function of β-catenin in the transformation of precancerous colorectal lesions into CRC, when collaborating with PI3K/AKT/mTOR signaling pathway and other mechanisms. The existing methods for the early diagnostics and prevention of discovered anomalies are described and categorized. The analysis of the approaches to chemoprophylaxis of CRC, depending on the results of endoscopic, morphological and molecular-genetic tests, is presented.

摘要

在现代综合检查方案中,结肠直肠癌(CRC)及结肠癌前病变的诊断是最亟待考虑的问题之一。该方案建议从45岁起使用,包括仪器检查和实验室研究方法:结肠镜检查、CT结肠成像、乙状结肠镜检查、粪便潜血试验、粪便免疫组化试验和粪便DNA检测。然而,切除这些癌前病变并不能解决问题,除了对有CRC高发病风险的患者进行定期内镜监测外,还需要对导致CRC发生的某些关键致病机制进行药物治疗。本综述讨论了β-连环蛋白在结直肠癌前病变转化为CRC过程中的作用,以及它与PI3K/AKT/mTOR信号通路和其他机制的协同作用。描述并分类了现有的早期诊断和预防已发现异常的方法。根据内镜、形态学和分子遗传学检测结果,对CRC化学预防方法进行了分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6887/11019464/13ef52fcae43/mi-04-03-00149-g00.jpg

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