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🌱 來自: colorectal cancer

Pathophysiology of colorectal cancer

• Assoc Cancers

• Hereditary nonpolyposis colorectal cancer (HNPCC or Lynch)

• ~80%

• lifetime

• Most common hered. CRC (~3%). Mismatch repair mut (eg, MSH2, MLH1). Dx: ≥3 family HNPCC cancer, 1 dx before 50 y, involves 2 gen. Typically right-sided.

• Endometrial, ovarian, stomach, urothelial, small bowel & pancreas

• Familial adeno polyposis (FAP)

• 100% lifetime

• Mutation in APC gene → 1000s of polyps at ↣ young age

• Thyroid, stomach, small bowel

• MUTYH-assoc. polyposis (MAP)

• 40-100% lifetime

• Autosomal recessive; consider if mult. polyps but ⊖ for FAP

• Duodenal, ovarian, bladder, skin

• ASA rec for 1° prev. if 50-59 y & ≥10% 10-y CRC risk. Must take for at ↣ least 10 years.

Relevant therapeutic targets in metastatic CRC.