Stem cells in gastrointestinal cancers: a matter of choice in cell fate determination

Cancerous stem cells share the same properties of self-renewal and differentiation as normal stem cells, and have a similar phenotype to adult stem cells isolated from the same tissue. Some believe that cancer stem cells are derived from mutation of normal stem cells, whereas others suspect them to have different origins. Although complicated and controversial, the stem cell as the progenitor of cancer has found support in leukemia research, and subsequently in some solid tumors. It was first accepted that both stem and progenitor cells could acquire genetic abnormalities that would lead to uncontrolled replication and dysregulated differentiation, causing them to transform into cancerous stem cells that might then initiate and maintain a tumor. In this article, we discuss recent progress in the studies of stomach and intestinal cancer stem cells, while focusing on the complex molecular pathways underlying stem cell transformation and gastrointestinal tumorigenesis. This understanding provides a basis for promising new therapies that may specifically target gastrointestinal cancer stem cells.