Cited by 606Genetic factors in colorectal cancerColorectal Cancer Treatments and StudiesColorectal Cancer Screening and Detection

Pathways of Colorectal Carcinogenesis

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Nguyen, Long H., Goel, Ajay, Chung, Daniel C.·2020·Gastroenterology

Abstract

Colorectal cancer is a heterogeneous disease that develops via stepwise accumulation of well-characterized genetic and epigenetic alterations. We review the genetic changes associated with the development of precancerous colorectal adenomas and their progression to tumors, as well as the effects of defective DNA repair, chromosome instability, microsatellite instability, and alterations in the serrated pathway and DNA methylation. We provide insights into the different molecular subgroups of colorectal tumors that develop via each of these different mechanisms and their associations with patient outcomes.

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Crossref · 10.1053/j.gastro.2019.08.059

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  • The initiating event for adenomas is mutation in APC, a component of the destruction complex that degrades β-catenin, while the initiating event for serrated polyps involves an activating mutation in the BRAF oncogene.

    “The initiating event for adenomas is mutation in APC, a component of the destruction complex that degrades β-catenin, while the initiating event for serrated polyps involves an activating mutation in the BRAF oncogene [18].”
  • The adenoma-to-carcinoma progression proceeds via the chromosomal instability (CIN) pathway in ~65-70% of sporadic CRC with the MSI pathway (~15%) and serrated neoplasia (~15%) alternative pathways of CRC carcinogenesis.

    “The adenoma-to-carcinoma progression proceeds via the chromosomal instability (CIN) pathway in ~65–70% of sporadic CRC with the MSI pathway (~15%) and serrated neoplasia (~15%) alternative pathways of CRC carcinogenesis [18].”

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Authors
Nguyen, L. H., Goel, A., & Chung, D. C.
Affiliations
  • Harvard University (US)
  • City Of Hope National Medical Center (US)
Corresponding author
  • Goel, Ajay
  • Chung, Daniel C.
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2020-01
Volume
158
Issue
2
Pages
291-302
ISSN
0016-5085 (ISSN-L)
OpenAlex
W2979482964
Cited by
606
References
153
Citations by year
2026: 97 · 2025: 137 · 2024: 98 · 2023: 89 · 2022: 85 · 2021: 72 · 2020: 27 · 2014: 1
FWCI
7.18
Type
journal article
Language
en
Open access
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
Keywords
colorectal carcinogenesis, colorectal adenoma, serrated pathway, DNA repair deficiency, chromosomal instability, microsatellite instability, DNA methylation, epigenetic modifications, genetic alterations, patient outcomes
MeSH terms
Adenoma, Humans, Mutation, Colorectal Neoplasms, Gene Expression Regulation, Neoplastic, Disease Progression, DNA Methylation, Epigenesis, Genetic, Microsatellite Instability, Carcinogenesis

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