Kennedy E P, Hamilton S R
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Semin Surg Oncol. 1998 Sep;15(2):126-30. doi: 10.1002/(sici)1098-2388(199809)15:2<126::aid-ssu10>3.0.co;2-0.
Recent years have brought great advances in the understanding of the pathogenesis of colorectal cancers. The elucidation of the underlying genetic alterations that produce these cancers has made it possible to broadly categorize this disease into two major types, hereditary and sporadic. The hereditary cancers have been divided further into recognized syndromes, mainly familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer. These syndromes have unique clinical pictures and different prognoses in addition to their different genetic bases. Sporadic cancers have been found to have analogous genetic alterations which propel them along the progression from normal tissue to benign adenoma/dysplasia to malignancy. These advances in genetics can potentially lead to clinically useful advances in detection, treatment, and, ultimately, prevention of colorectal cancer.
近年来，在对结直肠癌发病机制的认识方面取得了巨大进展。对引发这些癌症的潜在基因改变的阐明，使得将这种疾病大致分为两种主要类型成为可能，即遗传性和散发性。遗传性癌症进一步细分为已确认的综合征，主要是家族性腺瘤性息肉病和遗传性非息肉病性结直肠癌。这些综合征除了具有不同的基因基础外，还具有独特的临床表现和不同的预后。已发现散发性癌症具有类似的基因改变，这些改变促使它们从正常组织发展为良性腺瘤/发育异常再到恶性肿瘤。遗传学上的这些进展可能会在结直肠癌的检测、治疗以及最终预防方面带来临床上有用的进展。
