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Effect of Climate Change on Lung Cancer
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作者 Shivansh Sharma 《Health》 2024年第1期60-71,共12页
This research paper aims to draw a relationship between lung cancer and climate change. With the rise of climate change in the last few decades, many organizations and people are concerned about the future of the worl... This research paper aims to draw a relationship between lung cancer and climate change. With the rise of climate change in the last few decades, many organizations and people are concerned about the future of the world. Climate change has many side effects, such as air pollution, which can increase the incidence and death rates of lung and bronchus cancer. This paper aims to draw the relationship between climate change factors and lung cancer incidence and mortality rates. The main finding of this analysis was that there is a positive relationship between lung cancer incidence, death rates, and climate change indicators. The findings from this study have the potential to inform targeted public health interventions and policies, emphasizing the need for proactive strategies in mitigating the health impacts of a changing climate. Section 2 of this paper is a literature review and focuses on the findings of other scholars in this field. Section 3 of this paper is Methods and Processes and will highlight the steps used to create the program and get the results. Section 4 of this paper is Results and Analysis, and will go over the results produced by the machine learning algorithm, and will present graphs and visualizations regarding the relationship of the dependent and independent variables. The final section, Section 5, is Limitations and Conclusion, in which we will discuss possible limitations to both my dataset and my model, and will conclude the paper by presenting a big-picture view of these problems in our society. 展开更多
关键词 cancer Lung cancer Climate Change
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Why is early detection of colon cancer still not possible in 2023?
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作者 Valeria Tonini Manuel Zanni 《World Journal of Gastroenterology》 SCIE CAS 2024年第3期211-224,共14页
Colorectal cancer(CRC)screening is a fundamental tool in the prevention and early detection of one of the most prevalent and lethal cancers.Over the years,screening,particularly in those settings where it is well orga... Colorectal cancer(CRC)screening is a fundamental tool in the prevention and early detection of one of the most prevalent and lethal cancers.Over the years,screening,particularly in those settings where it is well organized,has succeeded in reducing the incidence of colon and rectal cancer and improving the prognosis related to them.Despite considerable advancements in screening technologies and strategies,the effectiveness of CRC screening programs remains less than optimal.This paper examined the multifaceted reasons behind the persistent lack of effect-iveness in CRC screening initiatives.Through a critical analysis of current methodologies,technological limitations,patient-related factors,and systemic challenges,we elucidated the complex interplay that hampers the successful reduction of CRC morbidity and mortality rates.While acknowledging the ad-vancements that have improved aspects of screening,we emphasized the necessity of addressing the identified barriers comprehensively.This study aimed to raise awareness of how important CRC screening is in reducing costs for this disease.Screening and early diagnosis are not only important in improving the prognosis of patients with CRC but can lead to an important reduction in the cost of treating a disease that is often diagnosed at an advanced stage.Spending more sooner can mean saving money later. 展开更多
关键词 Colorectal cancer Colorectal cancer screening Colorectal screening test Colon and rectal cancer
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Genomic medicine and cancer clinical trial in Thailand
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作者 Lucksamon Thamlikitkul Napa Parinyanitikul Virote Sriuranpong 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第1期10-15,共6页
Introduction Cancer treatment has been revolutionized with the advent of targeted therapy and immunotherapy.In the past,when cancer treatment modalities were restricted,conventional chemotherapy was the only option fo... Introduction Cancer treatment has been revolutionized with the advent of targeted therapy and immunotherapy.In the past,when cancer treatment modalities were restricted,conventional chemotherapy was the only option for systemic disease.Because chemotherapy empirically affects all dividing cells,the targets are virtually non-specific.In this regard,toxic effects on normal tissue are essentially inevitable. 展开更多
关键词 CHEMOTHERAPY cancer cancer
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Circulating cell-free mtDNA as a new biomarker for cancer detection and management
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作者 Fan Peng Siyuan Wang +5 位作者 Zehui Feng Kaixiang Zhou Huanqin Zhang Xu Guo Jinliang Xing Yang Liu 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第2期105-110,共6页
Cancer is a major cause of death worldwide,and was responsible for 19.29 million new cases and 9.96 million deaths in 2020 alone.The total number of patients with cancer worldwide is estimated to reach 28 million by 2... Cancer is a major cause of death worldwide,and was responsible for 19.29 million new cases and 9.96 million deaths in 2020 alone.The total number of patients with cancer worldwide is estimated to reach 28 million by 2040.The American Association for Cancer Research has also estimated approximately 16.2 million cancer deaths by 20401. 展开更多
关键词 cancer cancer DEATH
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Current and future trends in whole genome sequencing in cancer
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作者 Yuki Katsuya 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第1期16-20,共5页
Cancer remains a formidable global health challenge affecting millions of lives annually.For decades,conventional cancer treatments used a one-size-fits-all approach,overlooking the intricate genetic variations that d... Cancer remains a formidable global health challenge affecting millions of lives annually.For decades,conventional cancer treatments used a one-size-fits-all approach,overlooking the intricate genetic variations that drive tumors.The emergence of cancer genomics has ushered in a new era of personalized and targeted cancer therapies.The Human Genome Project,which was launched in 1990 and completed in 2003。 展开更多
关键词 cancer cancer annually
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DNA methylation profiles in cancer:functions,therapy,and beyond
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作者 Jinrong Zhu Yongjie Yang +2 位作者 Li Li Jiuren Tang Rongxin Zhang 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第2期111-116,共6页
DNA methylation in cancer DNA methylation,a reversible post-replication modification,defines gene expression and function in different physiologic processes.Hypomethylation is quite common among global DNA modificatio... DNA methylation in cancer DNA methylation,a reversible post-replication modification,defines gene expression and function in different physiologic processes.Hypomethylation is quite common among global DNA modifications,while promoter hypermethylation often occurs in local regions during cancer,as in CpG island formation,thereby perpetuating the inactivation of tumor suppressor genes. 展开更多
关键词 cancer SUPPRESSOR thereby
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Double role of depression in gastric cancer:As a causative factor and as consequence
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作者 Grigorios Christodoulidis Koumarelas Konstantinos-Eleftherios Kouliou Marina-Nektaria 《World Journal of Gastroenterology》 SCIE CAS 2024年第10期1266-1269,共4页
In this editorial we comment on the article“Hotspots and frontiers of the rela-tionship between gastric cancer and depression:A bibliometric study”.Gastric cancer(GC)is a common malignancy in the digestive system wi... In this editorial we comment on the article“Hotspots and frontiers of the rela-tionship between gastric cancer and depression:A bibliometric study”.Gastric cancer(GC)is a common malignancy in the digestive system with increased mortality and morbidity rates globally.Standard treatments,such as gastrectomy,negatively impact patients'quality of life and beyond the physical strain,GC patients face psychological challenges,including anxiety and depression.The prevalence of depression can be as high as 57%,among gastrointestinal cancer patients.Due to the advancements in treatment effectiveness and increased 5-year overall survival rates,attention has shifted to managing psychological effects.However,the significance of managing the depression doesn’t lie solely in the need for a better psychological status.Depression leads to chronic stress acti-vating the sympathetic nervous system and the hypothalamus-pituitary-adrenal axis,leading release of catecholamines inducing tumor proliferation,migration,and metastasis,contributing to GC progression.The dysregulation of neurotrans-mitters and the involvement of various signaling pathways underscore the complex interplay between depression and GC.Comprehensive strategies are required to address the psychological aspects of GC,including region-specific interventions and increased monitoring for depression.Understanding the intricate relationship between depression and GC progression is essential for developing effective therapeutic strategies and improving overall outcomes for patients facing this complex disease.In this Editorial we delve into double role of depression in the pathogenesis of GC and as a complication of it. 展开更多
关键词 Gastric cancer DEPRESSION ANXIETY Chronic stress Pathogenesis of gastric cancer
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Roles and application of exosomes in the development,diagnosis and treatment of gastric cancer
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作者 Xiao-Li Guan Xiao-Ying Guan Zheng-Yi Zhang 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第3期630-642,共13页
As important messengers of intercellular communication,exosomes can regulate local and distant cellular communication by transporting specific exosomal con-tents and can also promote or suppress the development and pr... As important messengers of intercellular communication,exosomes can regulate local and distant cellular communication by transporting specific exosomal con-tents and can also promote or suppress the development and progression of gas-tric cancer(GC)by regulating the growth and proliferation of tumor cells,the tumor-related immune response and tumor angiogenesis.Exosomes transport bioactive molecules including DNA,proteins,and RNA(coding and noncoding)from donor cells to recipient cells,causing reprogramming of the target cells.In this review,we will describe how exosomes regulate the cellular immune respon-se,tumor angiogenesis,proliferation and metastasis of GC cells,and the role and mechanism of exosome-based therapy in human cancer.We will also discuss the potential application value of exosomes as biomarkers in the diagnosis and treat-ment of GC and their relationship with drug resistance. 展开更多
关键词 EXOSOMES Gastric cancer Immune regulation DIAGNOSIS cancer therapy
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Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?
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作者 Nobukazu Agatsuma Takahiro Utsumi +11 位作者 Yoshitaka Nishikawa Takahiro Horimatsu Takeshi Seta Yukitaka Yamashita Yukari Tanaka Takahiro Inoue Yuki Nakanishi Takahiro Shimizu Mikako Ohno Akane Fukushima Takeo Nakayama Hiroshi Seno 《World Journal of Gastroenterology》 SCIE CAS 2024年第10期1368-1376,共9页
BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of... BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the cancer screening group vs follow-up group=1.11;95%CI=0.82-1.49).CONCLUSION CRCs detected during hospital visits for comorbidities were diagnosed earlier,similar to cancer screening.CRC screening should be recommended,particularly for patients without periodical hospital visits for comorbidities. 展开更多
关键词 Colorectal neoplasms cancer registry Diagnostic route cancer screening Stage at diagnosis
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Peptide drugs: a new direction in cancer immunotherapy
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作者 Xinghua Sui Xiaoshuang Niu +1 位作者 Xiuman Zhou Yanfeng Gao 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第3期198-203,共6页
Cancer immunotherapy has emerged as a promising approach in cancer treatment and is considered a major advancement after surgical interventions, radiotherapy, chemotherapy, and targeted therapy. The clinical use of im... Cancer immunotherapy has emerged as a promising approach in cancer treatment and is considered a major advancement after surgical interventions, radiotherapy, chemotherapy, and targeted therapy. The clinical use of immunotherapeutic drugs, particularly antibody-based drugs that target immune checkpoints, has notably increased~1. 展开更多
关键词 DRUGS IMMUNOTHERAPY cancer
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Opportunities and challenges of CD47-targeted therapy in cancer immunotherapy
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作者 QIUQIANG CHEN XUEJUN GUO WENXUE MA 《Oncology Research》 SCIE 2024年第1期49-60,共12页
Cancer immunotherapy has emerged as a promising strategy for the treatment of cancer,with the tumor microenvironment(TME)playing a pivotal role in modulating the immune response.CD47,a cell surface protein,has been id... Cancer immunotherapy has emerged as a promising strategy for the treatment of cancer,with the tumor microenvironment(TME)playing a pivotal role in modulating the immune response.CD47,a cell surface protein,has been identified as a crucial regulator of the TME and a potential therapeutic target for cancer therapy.However,the precise functions and implications of CD47 in the TME during immunotherapy for cancer patients remain incompletely understood.This comprehensive review aims to provide an overview of CD47’s multifaced role in TME regulation and immune evasion,elucidating its impact on various types of immunotherapy outcomes,including checkpoint inhibitors and CAR T-cell therapy.Notably,CD47-targeted therapies offer a promising avenue for improving cancer treatment outcomes,especially when combined with other immunotherapeutic approaches.The review also discusses current and potential CD47-targeted therapies being explored for cancer treatment and delves into the associated challenges and opportunities inherent in targeting CD47.Despite the demonstrated effectiveness of CD47-targeted therapies,there are potential problems,including unintended effects on healthy cells,hematological toxicities,and the development if resistance.Consequently,further research efforts are warranted to fully understand the underlying mechanisms of resistance and to optimize CD47-targeted therapies through innovative combination approaches,ultimately improving cancer treatment outcomes.Overall,this comprehensive review highlights the significance of CD47 as a promising target for cancer immunotherapy and provides valuable insight into the challenges and opportunities in developing effective CD47-targeted therapies for cancer treatment. 展开更多
关键词 CD47 cancer immunotherapy CD47-targeted therapies Tumor microenvironment MACROPHAGE cancer cell Immune evasion Checkpoint inhibitors CAR T-cell therapy cancer treatment outcomes
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Erratum to Treatment strategies for patients with HER2-positive gastric cancer
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作者 Feixue Wang Yi Ba 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第3期F0003-F0003,共1页
For the affiliation information,the affiliation for author Feixue Wang should be Department of GI Medical Oncology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,... For the affiliation information,the affiliation for author Feixue Wang should be Department of GI Medical Oncology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin's Clinical Research Center for Cancer,Tianjin Key Laboratory of Digestive Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin Medical University,Tianjin 300060,China. 展开更多
关键词 cancer CLINICAL MEDICAL
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Trends in colorectal cancer incidence according to an increase in the number of colonoscopy cases in Korea
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作者 Ga Hee Kim Yeong Chan Lee +8 位作者 Tae Jun Kim Sung Noh Hong Dong Kyung Chang Young-Ho Kim Dong-Hoon Yang Chang Mo Moon Kyunga Kim Hyun Gun Kim Eun-Ran Kim 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第1期51-60,共10页
BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several countries.AIM To evaluate the trend in incidence of CRC and preinva... BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several countries.AIM To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea.METHODS This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC,and assess the numbers of diagnostic colonoscopies and colonoscopic polypectomies.Colonoscopy-related complications by age group were also determined.RESULTS The incidence of CRC showed a rapid increase,then decreased after 2012 in the 50-75 year-age group.During the study period,the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of age.Since 2009,the increase has been rapid,showing a pattern similar to the increase in colonoscopies.The rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after 2007.The rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of age.CONCLUSION The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies performed.As the risk of colonoscopy-related hospitalization and death is high in the elderly,if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75,colonoscopy-related complications can be reduced for those aged 76 years or over. 展开更多
关键词 Colorectal cancer Preinvasive colorectal cancer Colorectal polypectomy COLONOSCOPY
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First-line immunotherapy for advanced non-small cell lung cancer:current progress and future prospects
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作者 Jingyi Wang Lin Wu 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第2期117-124,共8页
Global Cancer Statistics 2022 reported the prevalence and high mortality rate of lung cancer.Notably,non-small cell lung cancer(NSCLC)accounts for the majority of the histologic types1.Precision therapy for lung cance... Global Cancer Statistics 2022 reported the prevalence and high mortality rate of lung cancer.Notably,non-small cell lung cancer(NSCLC)accounts for the majority of the histologic types1.Precision therapy for lung cancer has progressed rapidly and immune checkpoint inhibitors(ICIs)have become a leading research topic.Indeed,ICI therapy has been shown to improve the prognosis of lung cancer patients. 展开更多
关键词 LUNG cancer MORTALITY
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Mission of the National Cancer Center Hospital in Japan to promote clinical trials for precision medicine
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作者 Kazuaki Shimada Kenichi Nakamura Noboru Yamamoto 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第1期1-3,共3页
Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main o... Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main obstacles are associated with the quality of samples used for genomic analysis。 展开更多
关键词 clinical cancer OVERCOME
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Improving the value of molecular testing:current status and opportunities in colorectal cancer precision medicine
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作者 Haiyun Li Linwei Guo +2 位作者 Chenchen Wang Xin Hu Ye Xu 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第1期21-28,共8页
Colorectal cancer(CRC)is the second leading cause of cancer-related deaths worldwide1.Surgical radical resection with adjuvant chemotherapy remains the primary treatment choice for CRC,but the 5-year postoperative sur... Colorectal cancer(CRC)is the second leading cause of cancer-related deaths worldwide1.Surgical radical resection with adjuvant chemotherapy remains the primary treatment choice for CRC,but the 5-year postoperative survival rate is only approximately 60%,and approximately one-third of patients with CRC experience recurrence within 2 years of surgery2.Fortunately,the transformation of high-throughput sequencing has accelerated the development of precision medicine.For example,KRAS mutations indicate resistance to anti-epidermal growth factor receptor(EGFR)-targeted therapies in CRC3.Furthermore,molecular-guided individualized therapy has brought new promise in major clinical areas and challenges,such as novel biomarkers predicting sensitivity and resistance to immunotherapy for microsatellite stable(MSS)CRC. 展开更多
关键词 cancer CHEMOTHERAPY COLORECTAL
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Prognostic and predictive role of immune microenvironment in colorectal cancer
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作者 Olesya Kuznetsova Mikhail Fedyanin +8 位作者 Larisa Zavalishina Larisa Moskvina Olga Kuznetsova Alexandra Lebedeva Alexey Tryakin Galina Kireeva Gleb Borshchev Sergei Tjulandin Ekaterina Ignatova 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第3期643-652,共10页
Colorectal cancer(CRC)represents a molecularly heterogeneous disease and one of the most frequent causes of cancer-related death worldwide.The traditional classification of CRC is based on pathomorphological and molec... Colorectal cancer(CRC)represents a molecularly heterogeneous disease and one of the most frequent causes of cancer-related death worldwide.The traditional classification of CRC is based on pathomorphological and molecular character-istics of tumor cells(mucinous,ring-cell carcinomas,etc.),analysis of mechanisms of carcinogenesis involved(chromosomal instability,microsatellite instability,CpG island methylator phenotype)and mutational statuses of commonly altered genes(KRAS,NRAS,BRAF,APC,etc.),as well as expression signatures(CMS 1-4).It is also suggested that the tumor microenvironment is a key player in tumor progression and metastasis in CRC.According to the latest data,the immune microenvironment can also be predictive of the response to immune checkpoint inhibitors.In this review,we highlight how the immune environment influences CRC prognosis and sensitivity to systemic therapy. 展开更多
关键词 Immunoscore Immune microenvironment Colorectal cancer Gastrointestinal cancers Predictive biomarkers Digital pathology
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A robust genomic-based prognostic model for the assessment ofcancer stemness and survival for patients with hepatocellularcarcinoma
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作者 Cheng-Li Du Shen-Yu Wei +1 位作者 Yun-Hao Chen Kang-Jie Chen 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第1期97-102,共6页
To the Editor:Hepatocellular carcinoma(HCC)is an aggressive malignancy with poor long-term prognosis[1].Liver cancer stem cell(CSC)can drive the metastasis,drug resistance,and recurrence of HCC[2].The regulatory mecha... To the Editor:Hepatocellular carcinoma(HCC)is an aggressive malignancy with poor long-term prognosis[1].Liver cancer stem cell(CSC)can drive the metastasis,drug resistance,and recurrence of HCC[2].The regulatory mechanisms about liver cancer stemness have been investigated,which encouraged the identification and characterization of novel prognostic and therapeutic strategies for HCC[3]. 展开更多
关键词 cancer PROGNOSIS LIVER
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Perspective on new cell-free DNA technologies for early cancer detection
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作者 Jie Li Xun Lan 《Cancer Biology & Medicine》 SCIE CAS CSCD 2024年第2期139-143,共5页
High cancer heterogeneity and aggressiveness are major factors contributing to the poor prognosis of patients with advanced cancer~(1-5).Early detection of cancer can significantly improve the prognosis of patients wi... High cancer heterogeneity and aggressiveness are major factors contributing to the poor prognosis of patients with advanced cancer~(1-5).Early detection of cancer can significantly improve the prognosis of patients with early-stage cancer after standard treatment.Although traditional cancer detection technologies,such as endoscopy for gastrointestinal cancer,mammography for breast cancer。 展开更多
关键词 PROGNOSIS cancer PATIENTS
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Biological factors driving colorectal cancer metastasis
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作者 Shuai-Xing An Zhao-Jin Yu +2 位作者 Chen Fu Min-Jie Wei Long-Hai Shen 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第2期259-272,共14页
Approximately 20%of colorectal cancer(CRC)patients present with metastasis at diagnosis.Among Stage I-III CRC patients who undergo surgical resection,18%typically suffer from distal metastasis within the first three y... Approximately 20%of colorectal cancer(CRC)patients present with metastasis at diagnosis.Among Stage I-III CRC patients who undergo surgical resection,18%typically suffer from distal metastasis within the first three years following initial treatment.The median survival duration after the diagnosis of metastatic CRC(mCRC)is only 9 mo.mCRC is traditionally considered to be an advanced stage malignancy or is thought to be caused by incomplete resection of tumor tissue,allowing cancer cells to spread from primary to distant organs;however,increa-sing evidence suggests that the mCRC process can begin early in tumor development.CRC patients present with high heterogeneity and diverse cancer phenotypes that are classified on the basis of molecular and morphological alterations.Different genomic and nongenomic events can induce subclone diversity,which leads to cancer and metastasis.Throughout the course of mCRC,metastatic cascades are associated with invasive cancer cell migration through the circulatory system,extravasation,distal seeding,dormancy,and reactivation,with each step requiring specific molecular functions.However,cancer cells presenting neoantigens can be recognized and eliminated by the immune system.In this review,we explain the biological factors that drive CRC metastasis,namely,genomic instability,epigenetic instability,the metastatic cascade,the cancer-immunity cycle,and external lifestyle factors.Despite remarkable progress in CRC research,the role of molecular classification in therapeutic intervention remains unclear.This review shows the driving factors of mCRC which may help in identifying potential candidate biomarkers that can improve the diagnosis and early detection of mCRC cases. 展开更多
关键词 cancer Metastasis cascade cancer immunity Genomic variation Epigenetic instability Lifestyle factor
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