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🌱 來自: Colon Cancer

Pathophysiology of Colon Cancer

• Adenoma-CA sequence:
  • Most common pathway, adenomas on avg take 10 y to develop (Cell 1990;61:759).
  • Accumulation of genetic muts (APC → TP53, KRAS, SMAD4, etc.) leads to tumorigenesis; usu a/w chromosomal instability (CIN); risk of CRC ↑ w/ adenoma size, number, & histology (villous > tubular)

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• Serrated polyp pathway:
  • Alternative route for CRC development through serrated adenomas;
  • BRAF mut & CpG Island Methylation Phenotype (CIMP);
  • hypermethylation of promoters of MMR genes such as MLH1 & tumor suppressors → gene silencing

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• Lynch