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Epidemiology, molecular changes, histopathology and diagnosis of colorectal cancer

Kolorektales Karzinom – Epidemiologie, Molekulare Mechanismen, Histopathologie und Diagnostik

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Zusammenfassung

HINTERGRUND: Das kolorektale Karzinom ist eine der häufigsten malignen Erkrankungen in den Industrienationen. Ungeachtet der zunehmenden Erkenntnisse über die Entstehung und das biologische Verhalten der Tumoren, verbesserter therapeutischer Konzepte und der steigenden Bereitschaft sowohl Vor- als auch Nachsorgeprogramme wahrzunehmen, bleibt es eine Erkrankung mit hoher Mortalität. METHODEN: Die PubMed-Datenbank wurde in Hinblick auf aktuelle Literatur in den Bereichen Epidemiologie, Entstehung, histopathologische Beurteilung und Diagnostik des kolorektalen Karzinoms gesichtet. ERGEBNISSE: Es wird ein Überblick über die epidemiologischen Daten bezüglich der Inzidenz, der geographischen Unterschiede und der Risikofaktoren gegeben. Die molekularen Mechanismen für die Entstehung kolorektaler Karzinome entlang der Adenom-Karzinom-Sequenz werden erläutert und zusätzliche Aspekte der Tumorbiologie wie Ploidestatus und Mikrosatelliteninstabilität diskutiert. Die standardmäßig in der histopathologischen Beurteilung untersuchten Parameter werden zusammengefasst, neue Kriterien vorgestellt und weitere prognostisch relevante Tumoreigenschaften aufgeführt. Die Diagnose sowie das Staging von Patienten mit einem kolorektalen Karzinom basieren auf diversen Untersuchungsmodalitäten, deren Effektivität, Sensitivität und Spezifität dargestellt werden. SCHLUSSFOLGERUNGEN: Die frühe Detektion kolorektaler Karzinome, das Verständnis von der Tumorheterogenität und die daraus resultierende Konzeption individualisierter Therapieansätze stellen essentielle Zielvorgaben dar, um das outcome von Patienten mit einem kolorektalen Karzinom weiter verbessern zu können.

Summary

BACKGROUND: Colorectal cancer is one of the most common malignant diseases in the industrialized nations. Despite advances in research on tumor development and biology, improved therapeutical concepts, and an increasing motivation to undergo screening examinations and surveillance programs the overall mortality remains high. METHODS: PubMed database was used to screen the current literature for the topics of epidemiology, colorectal cancer development, histopathologic features, and diagnosis in colorectal cancer. RESULTS: A general overview of epidemiologic data in terms of incidence, geographic differences in occurrence and risk factors is given. Molecular mechanisms for the formation of colorectal cancer within the adenoma-carcinoma sequence are explained and additional aspects such as ploidy-status of colorectal tumors and microsatellite instability put into perspective. Various variables of routine histopathologic evaluation are summarized, more advanced analyses explained and prognostically relevant features listed. Diagnostic workup and staging of patients with colorectal cancer are based on several different techniques which are discussed for their effectivity, sensibility and sensitivity. CONCLUSIONS: Early detection of colorectal cancer together with a more detailed understanding of tumor heterogeneity and the prospect of tailoring individualized therapeutical concepts constitute essential factors in order to further ameliorate the outcome of colorectal cancer patients.

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Authors and Affiliations

  1. Laboratory for Surgical Research, Department of Surgery, University of Lübeck, Lübeck, Germany

    T. Laubert, J. K. Habermann, F. G. Bader, T. Jungbluth, H. Esnaashari, H.-P. Bruch & U. J. Roblick

  2. Unit of Cancer Proteomics, Karolinska Biomics Center (KBC), Karolinska University Hospital Solna, Stockholm, Sweden

    J. K. Habermann, U. J. Roblick & G. Auer

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  1. T. Laubert
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  2. J. K. Habermann
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  3. F. G. Bader
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Laubert, T., Habermann, J., Bader, F. et al. Epidemiology, molecular changes, histopathology and diagnosis of colorectal cancer. Eur Surg 42, 252–259 (2010). https://doi.org/10.1007/s10353-010-0581-7

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