Colorectal cancer: genetic abnormalities, tumor progression, tumor heterogeneity, clonal evolution and tumor-initiating cells.
Colorectal cancer: genetic abnormalities, tumor progression, tumor heterogeneity, clonal evolution and tumor-initiating cells.
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DOI：
10.3390/medsci6020031
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发表时间：
2018-04-13
期刊：
影响因子：
--
通讯作者：
Castelli G
中科院分区：
文献类型：
--
作者：
Testa U;Pelosi E;Castelli G
结肠癌是全球第三大常见癌症。大多数结直肠癌的发生是散发性的，与遗传易感性或家族史无关;然而，20-30%的结直肠癌患者有结直肠癌家族史，其中5%的肿瘤发生在孟德尔遗传综合征的背景下。在许多患者中，结直肠癌的发展之前是良性肿瘤性病变：腺瘤性息肉或锯齿状息肉。过去几年进行的研究已经描述了结直肠癌中发生的主要分子变化，表明每个患者的肿瘤显示出2到8个驱动突变。包括基因表达研究在内的分子学研究的集合已经导致了两种结肠直肠癌的拟议分类，并确定了四/五个不重叠的组。快速更新的肠上皮细胞的稳态是由存在于肠隐窝基底水平的少量干细胞保证的。各种实验证据表明，结肠直肠癌可能源自肠干细胞的恶性转化或在恶性转化后获得干细胞特性的肠细胞。结肠癌干细胞似乎参与肿瘤的化疗耐药性、放射耐药性和复发。
Colon cancer is the third most common cancer worldwide. Most colorectal cancer occurrences are sporadic, not related to genetic predisposition or family history; however, 20–30% of patients with colorectal cancer have a family history of colorectal cancer and 5% of these tumors arise in the setting of a Mendelian inheritance syndrome. In many patients, the development of a colorectal cancer is preceded by a benign neoplastic lesion: either an adenomatous polyp or a serrated polyp. Studies carried out in the last years have characterized the main molecular alterations occurring in colorectal cancers, showing that the tumor of each patient displays from two to eight driver mutations. The ensemble of molecular studies, including gene expression studies, has led to two proposed classifications of colorectal cancers, with the identification of four/five non-overlapping groups. The homeostasis of the rapidly renewing intestinal epithelium is ensured by few stem cells present at the level of the base of intestinal crypts. Various experimental evidence suggests that colorectal cancers may derive from the malignant transformation of intestinal stem cells or of intestinal cells that acquire stem cell properties following malignant transformation. Colon cancer stem cells seem to be involved in tumor chemoresistance, radioresistance and relapse.