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首页> 外文期刊>Annals of Surgery >Driver Gene Mutations and Epigenetics in Colorectal Cancer
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Driver Gene Mutations and Epigenetics in Colorectal Cancer

机译：司机基因突变和结直肠癌的表观癌症

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Objective: The majority of patients with colorectal cancer are diagnosed with locally advanced and/or disseminated disease, and treatment options include surgery in combination with cytotoxic chemotherapy regimens, biologics, and/or radiotherapy. Thus, colorectal cancer remains a heavy burden on society and health care systems. Mounting evidence show that driver gene mutations play only part of the role in carcinogenesis. Epigenetics are strongly implicated in initiation and progression of colorectal cancer along with major players such as intestinal microbiotic dysbiosis and chronic mucosal inflammation. To assess phenotypic changes in proteins and gene expression, multigene expression signatures based on sequencing techniques have been developed to hopefully improve predictors of the tumor profile, immune response, and therapeutic outcomes. Our objective was to review current advances in the field and to update surgeons and academics on driver gene mutations and epigenetics in colorectal cancer. Background and methods: This is a narrative review studying relevant research published in the PUBMED database from 2012-2018. Results and conclusion: Increased understanding of the molecular biology will improve options to characterize colorectal cancer with regard to mutations and molecular pathways, including microsatellite instability, epigenetics, microbiota, and microenvironment. Research will inevitably improve risk group stratification and targeted treatment approaches. Epigenetic profiling and epigenetic modulating drugs will increase risk stratification, increase accessibility for DNA targeting chemotherapeutics and reduce cytotoxic drug resistance. New generation antibiotics such as biofilm inhibitors and quorum sensing inhibitors are being developed to target the carcinogenetic impact of colonic dysbiosis and inflammation.
机译：目的：大多数结肠直肠癌患者被诊断出患有当地先进和/或播散的疾病，治疗方案包括与细胞毒性化疗方案，生物学和/或放射疗法组合的手术。因此，结直肠癌仍然是社会和医疗保健系统的沉重负担。安装证据表明，驾驶员基因突变仅在致癌物中仅发挥作用。表皮能源强烈地涉及结直肠癌的开始和进展以及肠道微生物消带症和慢性粘膜炎症等主要球员。为了评估蛋白质和基因表达中的表型变化，已经开发了基于测序技术的多烯表达签名，以便希望改善肿瘤概况，免疫应答和治疗结果的预测因子。我们的目标是审查现场的当前进步，并更新外科癌症司机基因突变和表观癌症的外科医生和学术。背景和方法：这是2012 - 2018年在PubMed数据库中发表的相关研究的叙述性审查。结果与结论：提高对分子生物学的理解将改善表征结直肠癌关于突变和分子途径的选择，包括微卫星不稳定性，表观遗传学，微生物生物和微环境。研究将不可避免地改善风险组分层和有针对性的治疗方法。表观遗传分析和表观遗传调节药物将提高风险分层，增加DNA靶向化学治疗剂的可及性，降低细胞毒性耐药性。正在开发出新一代抗生素，如生物膜抑制剂和法定感测抑制剂，以靶向结肠消带症和炎症的致癌影响。

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