结直肠癌中锯齿状通路分子特征的研究进展

Advances in molecular characteristics of the serrated pathway in colorectal cancer

结直肠癌(colorectal cancer,CRC)是全球癌症死亡的主要原因之一。在过去的十年中,除了传统的腺瘤-癌途径,研究发现了另一种多步骤的癌变机制,即“锯齿状途径”,20%~30%的CRC来自锯齿状途径。锯齿状病变的高度异质性使其诊断和病理解释困难。因此,为了更好地分类和管理CRC,需要新的生物标志物以更高的敏感性和特异性区分无蒂锯齿状腺瘤/息肉(sessile serrated adenomas/polyps,SSA/Ps)和增生性息肉(hyperplastic polyps,HPs)。到目前为止,已经有几个分子改变与锯齿状CRC有关。此外,肠道菌群正在成为锯齿状途径的一种新的生物标志物。本文阐述了与锯齿状CRC相关的遗传、表观遗传改变,以及微生物群特征及其临床意义的最新研究进展。

Colorectal cancer(CRC)is one of the leading causes of cancers death worldwide.In the past decade,in addition to the traditional adenomato-cancer pathway,research has identified another multi-step mechanism of carcinogenesis,the″serrated pathway″,from which approximately 20%-30%of CRC originate.The high heterogeneity of serrated lesions makes diagnosis and pathological interpretation difficult.Therefore,in order to better classify and manage CRC,new biomarkers are needed to distinguish sessile serrated adenomas/polyps(SSA/Ps)from hyperplastic polyps(HPs)with higher sensitivity and specificity.So far,several molecular alterations have been associated with serrated CRC.In addition,the gut microbiota is emerging as a new biomarker for the serrated pathway.This article reviewed the recent research advances in genetic and epigenetic changes associated with serrated CRC,as well as microbiota characteristics and their clinical significance.