CAJ | 학술논문

结直肠癌不是单纯的一个病，而是表现各异的一组异质性疾病，相似临床病理特征的肿瘤对治疗的反应和预后可能显著不同。因此，在肿瘤TNM分期的基础上增加危险评估或基于分子进行分型非常必要。对结直肠癌的发生发展机制的深入研究，利于从源头上对其进行亚型分类，也有利于后续预防和治疗药物的研发。高通量技术的发展为更加全面系统地区分结直肠癌亚型提供了可能。目前，结直肠癌亚型联盟﹙CRCSC)将结直肠癌分为5种亚型但仍需验证。在临床诊治过程中，有明确指导意义的常规应用的分子标志物包括MSI、RAS、BRAF、PI3KCA和HER2。
결직장암불시단순적일개병，이시표현각이적일조이질성질병，상사림상병리특정적종류대치료적반응화예후가능현저불동。인차，재종류TNM분기적기출상증가위험평고혹기우분자진행분형비상필요。대결직장암적발생발전궤제적심입연구，리우종원두상대기진행아형분류，야유리우후속예방화치료약물적연발。고통량기술적발전위경가전면계통지구분결직장암아형제공료가능。목전，결직장암아형련맹﹙CRCSC)장결직장암분위5충아형단잉수험증。재림상진치과정중，유명학지도의의적상규응용적분자표지물포괄MSI、RAS、BRAF、PI3KCA화HER2。
[Absrtact] Colorectal cancer ﹙CRC) is not a single disease, but a group of wide spectrum of heterogeneous diseases, and tumors with similar clinicopathological features may react differently to treatments and have diverse prognosis. So complementary risk evaluation, or based on molecular biomarkers to further stratify colorectal cancer beyond TNM staging is necessary. Understanding mechanism of carcinogenesis is good for subtyping colorectal cancer as well as drug development. So far, 3 major pathways are thought to be related to CRC carcinogenesis, chromosome instability, microsatellite instability and CpG island hypermethylation. High throughput profiling enables to study the molecular basis for CRC more comprehensively and systemically. Several studies have defined 3-6 subtypes. Colorectal Cancer Subtype Consortium has made consensus to divide CRC into 5 subtypes based on pool analysis of available profiling data. Further validation is ongoing. There are only a few biomarkers which can be applied in daily practice, including MSI, RAS, BRAF, PI3KCA and HER2.