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Serrated colorectal cancer: Molecular classification, prognosis, and response to chemotherapy
Oscar Murcia1, Miriam Juárez1, Eva Hernández-Illán1
1Oscar Murcia, Miriam Juárez, Eva Hernández-Illán, Cecilia Egoavil, Mar Giner-Calabuig, María Rodríguez-Soler, Rodrigo Jover, Unidad de Gastroenterología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria Isabial, 03010 Alicante, Spain.
Abstract:
Molecular advances support the existence of an alternative pathway of colorectal carcinogenesis that is based on the hypermethylation of specific DNA regions that silences tumor suppressor genes. This alternative pathway has been called the serrated pathway due to the serrated appearance of tumors in histological analysis. New classifications for colorectal cancer (CRC) were proposed recently based on genetic profiles that show four types of molecular alterations: BRAF gene mutations, KRAS gene mutations, microsatellite instability, and hypermethylation of CpG islands. This review summarizes what is known about the serrated pathway of CRC, including CRC molecular and clinical features, prognosis, and response to chemotherapy.
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