HISTOPATHOLOGICAL AND MOLECULAR CHARACTERISTICS OF COLORECTAL CANCER – REVIEW OF THE SIGNIFICANCE OF THE EPITHELIAL-MESENHYMAL TRANSITION
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Abstract

Colorectal cancer (CRC) is the third most frequently diagnosed cancer and the second

most common cause of death among malignant neoplasms, including both sexes. The most

important prognostic and predictive factors for CRC are the histological type and grade of the

tumor, TNM stage of the tumor disease, lympho-vascular and perineural infiltration, tumor

budding and residual status. The molecular classification of CRC is based on its genetic

characteristics, cellular specifications, cancer microenvironment and immunological

characteristics, and is of great practical importance, as individual subtypes differ in their

clinical course and respond differently to chemotherapeutic and biological treatment.

Epithelial-mesenchymal transition (EMT) is a transdifferentiation process in which epithelial

cells acquire properties that are characteristic of mesenchymal cells. During neoplastic

progression, cancer cells acquire genetic and epigenetic features that affect oncogenic and

tumor suppressor genes, which ultimately results in the activation of the type III EMT

programme, giving them the potential to invade and metastasize, contributing to the stemness

of cancer cells, their resistance to drugs and immune response avoidance. Changes made in

cells, during EMT, can be reversible upon arrival at a suitable location for colonization, by a

process opposite to EMT, called mesenchymal-epithelial transition (MET), during which cells

regain characteristics of the epithelial phenotype. In most human cancer types, a complete shift

from an epithelial to a mesenchymal phenotype during EMT is rarely encountered, but most

cancers show partial EMT. Cells undergoing partial EMT are difficult to identify, due to their

phenotypic heterogeneity and variable expression of EMT markers. It is necessary to find new

biomarkers of EMT, especiallypartial EMT, as well as a better understanding of the relationship

between EMT and resistance to therapy, in order to develop new therapeutic approaches for

CRC.

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DOI: 10.5937/mp75-45064

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