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PATOGENIA GENETICA DEL CANCER COLORRECTAL. ACTUALIZACION

(especial para SIIC © Derechos reservados)
En esta revisión se destacan los avances más recientes en relación con la patogenia genética del cáncer colorrectal y la importancia de la inestabilidad cromosómica.
lynch9.jpg Autor:
John Lynch
Columnista Experto de SIIC

Institución:
Division of Gastroenterology University of Philadelphia

Artículos publicados por John Lynch
Recepción del artículo
20 de Diciembre, 2004 		Aprobación
28 de Diciembre, 2004
Primera edición
6 de Febrero, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

PATOGENIA GENETICA DEL CANCER COLORRECTAL. ACTUALIZACION

Resumen
El cáncer de colon es una causa significativa de morbilidad y mortalidad en todo el mundo. Los avances realizados durante los últimos años han mejorado nuestra comprensión sobre los mecanismos que gobiernan la carcinogénesis colorrectal y han comenzado a influir en el cuidado de los pacientes. Durante mucho tiempo se creyó que la progresión del epitelio normal del colon hacia el cáncer es, en cada caso, un proceso escalonado en el cual se pueden identificar marcadores patológicos y moleculares específicos para el estudio y el tratamiento clínico. Aunque para nosotros esta hipótesis es fundamental, en los últimos años ha habido una mayor apreciación de las diferencias entre los cánceres de colon individuales. En particular, el pensamiento actual sugiere que existen seis características cardinales que las células neoplásicas comparten, aunque los mecanismos por los cuales se adquieren pueden variar en forma considerable. Más notablemente, la inestabilidad genética parece ser de importancia fundamental para este proceso, lo que provee un ambiente adecuado para el surgimiento de estas características. Se ha avanzado en la comprensión de la génesis de la inestabilidad cromosómica (INC), la de tipo microsatelital (INM), la epigenética, así como en las mutaciones resultantes de los defectos en la escisión y reparación de las bases. Esta revisión destaca varios de los avances recientes más significativos en la carcinogénesis colorrectal, con énfasis en los mecanismos promotores de la inestabilidad genética.

Palabras clave
Cáncer de colon, inestabilidad genética, inestabilidad cromosómica, poliposis adenomatosa familiar, reparación y escisión de bases


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THE GENETIC PATHOGENESIS OF COLORECTAL CANCER—AN UPDATE

Abstract
Colon cancer remains a significant cause of morbidity and mortality world-wide. Advances in the last few years have improved our understanding of the mechanisms governing colorectal carcinogenesis and have begun to impact patient care. It has long been believed that the progression from normal colonic epithelium to colon cancer is in every case a step-wise process in which specific pathologic and molecular markers can be identified for study and clinical therapy. While this hypothesis remains central to our understanding, in the past few years there has been a greater appreciation of the differences between individual colon cancers. In particular, current thinking suggests there are six cardinal features neoplastic cells share in common, however the mechanisms by which they are acquired by cells can vary considerably. Most notably, genetic instability appears to be critically important to this process, providing an appropriate environment in which these cardinal features arise. Progress has been made in understanding the genesis of chromosomal instability (CIN), microsatellite instability (MIN), epigenetic instability, as well as the mutations resulting from base excision-repair defects. This review highlights several of the more significant recent advances in colorectal carcinogenesis, with an emphasis on mechanisms promoting genetic instability.

Key words
Colon cancer, genetic instability, chromosomal instability, familial adenomatosis polyposis, base excision-repair


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Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Gastroenterología, Genética Humana, Oncología
Relacionadas: Diagnóstico por Laboratorio, Gastroenterología, Genética Humana, Medicina Interna, Oncología



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