INTESTINE Vol.22 No.5(4)

Theme Molecular biology of colorectal tumors
Title Molecular alterations and histological diagnosis of colorectal tumors
Publish Date 2018/09
Author Tamotsu Sugai Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University
Author Makoto Eizuka Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University
[ Summary ] Colorectal cancer (CRC) is one of the most common cancer types worldwide and the leading cause of cancer related deaths. Although the molecular mechanisms of CRC carcinogenesis have been clarified, the complex molecular heterogeneity of this disease is not completely understood. At the molecular level, CRC can be subclassified into two primary categories, including microsatellite stable (MSS) and microsatellite instable (MSI) CRC. Whereas MSS CRC is characterized by multiple copy number alterations, DNA aneuploidy and TP53 mutation, MSI CRC is closely associated with the CpG island methylator phenotype and BRAF mutation. Meanwhile, in the adenoma-carcinoma sequence (ACS), serrated pathways and de novo carcinogenesis have been proposed as pathways leading to CRC development. Although ACS and de novo pathways are related to MSS CRC, the serrated pathway leads to MSI CRC. In recent studies, several hypotheses have been proposed from genome-wide comprehensive analyses. Recent advances in molecular biology will help identify cellular pathways disrupted by CRC. Knowledge gained through these studies may help elucidate the histopathological diagnosis of colorectal tumors.
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