대장암의 분자병리학적 분류
Classification of Colorectal Cancer Based on Clinical, Morphological and Molecular Features
박선후,
소속 상세정보
박선후 ( Park Sun-Hoo )
한국원자력의학원 원자력병원 병리과
KMID : 0356720080240060497
Abstract
Colorectal cancer (CRC) has been assumed for many years to be a homogenous condition with the vast majority developing within preexisting-adenomas. However, over the last two-decades, it has become clear that CRC evolves through multiple pathways at the genetic and the epigenetic level. Each of these processes is associated with a unique genetic or epigenetic signature identifiable in the tumor cells. The pathway may be defined on the basis of three molecular features: 1) chromosomal instability (CIN), 2) microsatellite instability (MSI), and 3) CpG island methylator phenotype (CIMP). Those molecular pathways are determined at an early evolutionary stage and are fully established within early cancer. Recently, five subgroups were outlined by using morphological findings and associated molecular changes: type 1 (CIN-stable/MSI-H/CIMP-H), type 2 (CIN-stable/MSI-L or MSS/CIMP-H), type 3 (CIN-unstable/MSI-L or MSS/CIMP-L), type 4 (CIN-instable/MSS/CIMP-neg), and type 5 (CINstable/MSI-H/CIMP-neg). This approach to the classification of CRC should accelerate understanding of causation and will have an impact on clinical management in the areas of both prevention and treatment.
키워드
결장직장암;유전적;후생학적;기전;분류
Colorectal cancer;Genetic;Epigenetic;Pathway;Classification
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