دانلود Genetics, diagnosis and management of colorectal cancer (Review)

Abstract

Colorectal cancer (CRC) is the third most common type of cancer worldwide and a leading cause of cancer death. Surgery represents the mainstay of treatment in early cases but often patients are primarily diagnosed in an advanced stage of disease and sometimes also distant metastases are present. Neoadjuvant therapy is therefore needed but drug resistance may influence response and concur to recurrent disease. At molecular level, it is a very heterogeneous group of diseases with  about  30%  of  hereditary  or  familial  cases.  During  colorectal adenocarcinomas development, epithelial cells from gastrointestinal trait acquire sequential genetic and epigenetic mutations  in  specific  oncogenes  and/or  tumour  suppressor  genes,  causing  CRC  onset,  progression  and  metastasis.  Molecular  characterization  of  cancer  associated  mutations  gives  valuable  information  about  disease  prognosis  and  response to the therapy. Very early diagnosis and personalised care, as well as a better knowledge of molecular basis of its onset and progression, are therefore crucial to obtain a cure of CRC. In this review, we describe updated genetics, current diagnosis and management of CRC pointing out the extreme need  for  a  multidisciplinary  approach  to  achieve  the  best results in patient outcomes.