Département de Chimie et Biochimie, Université de Moncton, Moncton, NB E1A 3E9, Canada.
Atlantic Cancer Research Institute, Moncton, NB E1C 8X3, Canada.
Int J Mol Sci. 2024 Aug 30;25(17):9463. doi: 10.3390/ijms25179463.
Colorectal cancer (CRC) represents a significant global health burden, with high incidence and mortality rates worldwide. Recent progress in research highlights the distinct clinical and molecular characteristics of colon versus rectal cancers, underscoring tumor location's importance in treatment approaches. This article provides a comprehensive review of our current understanding of CRC epidemiology, risk factors, molecular pathogenesis, and management strategies. We also present the intricate cellular architecture of colonic crypts and their roles in intestinal homeostasis. Colorectal carcinogenesis multistep processes are also described, covering the conventional adenoma-carcinoma sequence, alternative serrated pathways, and the influential Vogelstein model, which proposes sequential , , and alterations as drivers. The consensus molecular CRC subtypes (CMS1-CMS4) are examined, shedding light on disease heterogeneity and personalized therapy implications.
结直肠癌(CRC)是全球范围内的一个重大健康负担,其发病率和死亡率都很高。最近的研究进展强调了结肠癌和直肠癌在临床和分子特征上的明显区别,突出了肿瘤位置在治疗方法中的重要性。本文全面回顾了结直肠癌的流行病学、风险因素、分子发病机制和管理策略。我们还介绍了结肠隐窝的复杂细胞结构及其在肠道稳态中的作用。结直肠发生的多步骤过程也有描述,包括传统的腺瘤-癌序列、替代锯齿状途径以及有影响力的Vogelstein 模型,该模型提出了顺序的 、 、 改变作为驱动因素。还检查了共识分子 CRC 亚型(CMS1-CMS4),揭示了疾病异质性和个性化治疗的意义。