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대장암에서 유전자 불안정성의 임상적 의의

Genomic Instability in Colorectal Cancer; from Bench to Bed

대한대장항문학회지 2009년 25권 2호 p.129 ~ 138
이강영,
소속 상세정보
이강영 ( Rhee Kang-Young ) - 연세대학교 의과대학 외과학교실

Abstract


Colorectal cancer is a disease developed by the accumulation of genomic alteration. Two genomic instability pathways,
chromosomal instability pathway and microsatellite instability pathway, are known as the main pathways of the development of colorectal cancer. These are almost always mutually exclusive and tumors developed through each pathways show distinct clinicopathologic features. For the reason, molecular markers which represent each genomic instability pathways have been a candidate for translational research to find out prognostic or predictive factors. Loss of heterozygosity and aneuploidy are the hallmark of chromosomal instability and regarded as poor prognostic markers, whereas tumors with high frequency of microsatellite instability show better prognosis than microsatellite stable tumor. As a predictive factor of response from chemotherapy, loss of heterozygosity seems to be associated with a survival benefit from 5-FU adjuvant therapy. MSI-H has been reported as a predictive factor for poor response to 5-FU adjuvant chemotherapy. However, these molecular markers are not accepted to use in the clinic yet, since some of this kind of studies reported contradictory results. Further study wil be needed to make more concrete evidences for these markers and to identify new molecular markers for routine use in
the clinic.

키워드

대장암;미소위성체불안정성;염색체불안정성;분자생물학적표지자
Colorectal cancer;Microsatellite instability;Chromosomal instability;Molecular marker

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