[Pathological diagnosis for individualized therapy of colorectal cancer]

Area of Science:

• Oncology
• Molecular Pathology
• Cancer Genetics

Background:

• Pathological diagnosis is crucial for personalized colorectal cancer treatment.
• Molecular markers significantly influence therapeutic strategies and patient outcomes.
• Understanding genetic alterations in colorectal carcinomas is key to optimizing treatment.

Purpose of the Study:

• To highlight the importance of molecular pathological diagnosis in guiding colorectal cancer therapy.
• To correlate specific molecular markers (KRAS mutations, mismatch-repair deficiency, microsatellite instability) with treatment response.
• To evaluate the prognostic implications of high-grade microsatellite instability in colorectal carcinomas.

Main Methods:

• Routine molecular-pathological analysis of colorectal carcinomas.
• Detection of KRAS mutations.
• Assessment of mismatch-repair deficiency and microsatellite instability levels.

Main Results:

• KRAS mutation detection predicts unresponsiveness to EGFR-targeted antibody therapies.
• Mismatch-repair deficiency or high-degree microsatellite instability indicates unresponsiveness to 5-FU monotherapy.
• Colorectal carcinomas with high-grade microsatellite instability show a low risk of distant metastasis.

Conclusions:

• Molecular pathological findings are essential for individualized colorectal cancer therapy.
• Specific biomarkers predict treatment efficacy and resistance.
• High-grade microsatellite instability may identify colorectal cancers with a low need for adjuvant chemotherapy.