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Tumor Biology

, Volume 35, Issue 7, pp 6195–6206 | Cite as

Focus on genetic and epigenetic events of colorectal cancer pathogenesis: implications for molecular diagnosis

  • Federica Zoratto
  • Luigi Rossi
  • Monica Verrico
  • Anselmo Papa
  • Enrico Basso
  • Angelo Zullo
  • Luigi Tomao
  • Adriana Romiti
  • Giuseppe Lo Russo
  • Silverio Tomao
Review

Abstract

Originally, colorectal cancer (CRC) tumorigenesis was understood as a multistep process that involved accumulation of tumor suppressor genes and oncogenes mutations, such as APC, TP53 and KRAS. However, this assumption proposed a relatively limited repertoire of genetic alterations. In the last decade, there have been major advances in knowledge of multiple molecular pathways involved in CRC pathogenesis, particularly regarding cytogenetic and epigenetic events. Microsatellite instability, chromosomal instability and CpG island methylator phenotype are the most analyzed cytogenetic changes, while DNA methylation, modifications in histone proteins and microRNAs (miRNAs) were analyzed in the field of epigenetic alterations. Therefore, CRC development results from interactions at many levels between genetic and epigenetic amendments. Furthermore, hereditary cancer syndrome and individual or environmental risk factors should not be ignored. The difficulties in this setting are addressed to understand the molecular basis of individual susceptibility to CRC and to determine the roles of genetic and epigenetic alterations, in order to yield more effective prevention strategies in CRC patients and directing their treatment. This review summarizes the most investigated biomolecular pathways involved in CRC pathogenesis, their role as biomarkers for early CRC diagnosis and their possible use to stratify susceptible patients into appropriate screening or surveillance programs.

Keywords

Colorectal cancer pathogenesis Genetic events Epigenetic events Biomolecular markers 

Notes

Conflicts of interest

None

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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  • Federica Zoratto
    • 1
  • Luigi Rossi
    • 2
  • Monica Verrico
    • 2
  • Anselmo Papa
    • 2
  • Enrico Basso
    • 3
  • Angelo Zullo
    • 4
  • Luigi Tomao
    • 5
  • Adriana Romiti
    • 6
  • Giuseppe Lo Russo
    • 2
  • Silverio Tomao
    • 2
  1. 1.Oncology Unit 2Azienda Ospedaliera–Universitaria PisanaPisaItaly
  2. 2.Oncology Unit, ICOT, Department of Medico-Surgical Sciences and Biotechnologies“Sapienza” UniversityLatinaItaly
  3. 3.Oncology UnitPotenzaItaly
  4. 4.Gastroenterology DivisionRomeItaly
  5. 5.Biostatistics and Scientific DirectionRegina Elena National Cancer InstituteRomeItaly
  6. 6.Oncology Unit“Sapienza” UniversityRomeItaly

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