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Review
. 2018 Jan 20;10(1):26.
doi: 10.3390/cancers10010026.

Colorectal Cancers: An Update on Their Molecular Pathology

Kentaro Inamura  1
Affiliations
Review

Colorectal Cancers: An Update on Their Molecular Pathology

Kentaro Inamura. Cancers (Basel). .

Abstract

Colorectal cancers (CRCs) are the third leading cause of cancer-related mortality worldwide. Rather than being a single, uniform disease type, accumulating evidence suggests that CRCs comprise a group of molecularly heterogeneous diseases that are characterized by a range of genomic and epigenomic alterations. This heterogeneity slows the development of molecular-targeted therapy as a form of precision medicine. Recent data regarding comprehensive molecular characterizations and molecular pathological examinations of CRCs have increased our understanding of the genomic and epigenomic landscapes of CRCs, which has enabled CRCs to be reclassified into biologically and clinically meaningful subtypes. The increased knowledge of the molecular pathological epidemiology of CRCs has permitted their evolution from a vaguely understood, heterogeneous group of diseases with variable clinical courses to characteristic molecular subtypes, a development that will allow the implementation of personalized therapies and better management of patients with CRC. This review provides a perspective regarding recent developments in our knowledge of the molecular and epidemiological landscapes of CRCs, including results of comprehensive molecular characterizations obtained from high-throughput analyses and the latest developments regarding their molecular pathologies, immunological biomarkers, and associated gut microbiome. Advances in our understanding of potential personalized therapies for molecularly specific subtypes are also reviewed.

Keywords: chromosomal instability; colorectal cancer; microsatellite instability; molecular characterization; personalized therapy.

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Conflict of interest statement

The author declares no conflicts of interest.

Figures

Figure 1
Figure 1
The taxonomy of colorectal cancer according to the Colorectal Cancer Subtyping Consortium, reflecting biological differences in the gene expression-based molecular subtypes [3]. CIMP, CpG island methylator phenotype; CIN, chromosomal instability; CMS, consensus molecular subtype; EMT, epithelial–mesenchymal transition; MSI, microsatellite instability; MSS, microsatellite stable; SCNA, somatic copy number alteration.
Figure 2
Figure 2
Categorization into five subtypes based on MSI and CIMP status and presence of BRAF and KRAS mutations [8]. CIMP, CpG island methylator phenotype; CIN, chromosomal instability; CMS, consensus molecular subtype; CRC, colorectal cancer; EMT, epithelial–mesenchymal transition; MSI, microsatellite instability; MSS, microsatellite stable; SCNA, somatic copy number alteration.
See this image and copyright information in PMC

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