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The pathomorphologist’s role in the era of personalised therapy regarding the case of colorectal tumours
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Abstract
Colorectal cancer is one of the most common epithelial tumours amongst humans. Effective treatment requires a multidisciplinary approach and in some cases target therapy. In order to introduce treatment, both the clinical stage and pathomorphological diagnosis have to be taken into account. An analysis of the microscopic appearance as well as immunohistochemical and molecular tests are the basis of proper diagnosis. Biomarkers for diagnosis of colorectal cancer can be divided into two groups. The first one constitutes diagnostic and prognostic markers which are commonly used by pathologists. They are useful in the recognition of morphological and clinical features of tumours. The second group of biomarkers is used additionally and has predictive value. In an era of personalised therapy, the pathomrothologist’s role is to assess the prognostic and predictive biomarkers, in order to identify patients who will benefit from molecular targeted therapy. In the case of colorectal cancer mutations of genes: KRAS, NRAS and BRAF are clinically significant. A lack of the aforementioned mutations correlates with a better response to anti-EGRF therapy.
Abstract
Colorectal cancer is one of the most common epithelial tumours amongst humans. Effective treatment requires a multidisciplinary approach and in some cases target therapy. In order to introduce treatment, both the clinical stage and pathomorphological diagnosis have to be taken into account. An analysis of the microscopic appearance as well as immunohistochemical and molecular tests are the basis of proper diagnosis. Biomarkers for diagnosis of colorectal cancer can be divided into two groups. The first one constitutes diagnostic and prognostic markers which are commonly used by pathologists. They are useful in the recognition of morphological and clinical features of tumours. The second group of biomarkers is used additionally and has predictive value. In an era of personalised therapy, the pathomrothologist’s role is to assess the prognostic and predictive biomarkers, in order to identify patients who will benefit from molecular targeted therapy. In the case of colorectal cancer mutations of genes: KRAS, NRAS and BRAF are clinically significant. A lack of the aforementioned mutations correlates with a better response to anti-EGRF therapy.
Keywords
colorectal cancer, carcinogenesis pathways, prognostic biomarkers, predictive biomarkers, CIN, MSI, CIMP, BRAF mutations
About this articleTitle
The pathomorphologist’s role in the era of personalised therapy regarding the case of colorectal tumours
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
386-395
Published online
2017-03-29
Page views
674
Article views/downloads
929
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2016;66(5):386-395.
Keywords
colorectal cancer
carcinogenesis pathways
prognostic biomarkers
predictive biomarkers
CIN
MSI
CIMP
BRAF mutations
Authors
Małgorzata Kołos
Anna Nasierowska-Guttmejer
Anna Wasążnik-Jędras
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