期刊
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
卷 11, 期 8, 页码 723-729出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/17474124.2017.1330150
关键词
Big Bang model; colorectal cancer; CT colonography; tumor heterogeneity; tumorigenesis; punctuated equilibrium
资金
- National Cancer Institute [P30 CA014520, T32 CA009135, RO1CA194663, UO1CA152756]
- Department of Radiology, School of Medicine and Public Health at the University of Wisconsin
- Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine and Public Health at the University of Wisconsin
- Wisconsin Dual Sport Riders
- Tomorrow's Hope
- Lattner Foundation
- R.A.C.E. Charities
Introduction: Tumors in the large intestine have been postulated to arise via a stepwise accumulation of mutations, a process that takes up to 20 years. Recent advances in lineage tracing and DNA sequencing, however, are revealing new evolutionary models that better explain the vast amount of heterogeneity observed within and across colorectal tumors. Areas covered: A review of the literature supporting a novel model of colorectal tumor evolution was conducted. The following commentary examines the basic science and clinical evidence supporting a modified view of tumor initiation and progression in the colon. Expert commentary: The proposed 'cancer punctuated equilibrium' model of tumor evolution better explains the variability seen within and across polyps of the colon and rectum. Small colorectal polyps (6-9mm) followed longitudinally by interval imaging with CT colonography have been reported to have multiple fates: some growing, some remaining static in size, and others regressing in size over time. This new model allows for this variability in growth behavior and supports the hypothesis that some tumors can be 'born to be bad' as originally postulated by Sottoriva and colleagues, with very early molecular events impacting tumor fitness and growth behavior in the later stages of the disease process.
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