[Genetic alterations and molecular mechanisms underlying colorectal tumorigenesis]

Tumor cells are cells that have acquired damage to genes that directly regulate their cell cycles. In the multistep process leading to colorectal carcinoma, the adenoma-carcinoma sequence is characterized by progressive accumulation of genetic abnormalities (K-ras oncogene mutation, allelic deletion on chromosome 5q, 18q, 17p). In a hereditary non-polyposis syndrome (Lynch syndrome II) and in about a quarter of the cases of sporadic colorectal cancer there is a DNA micro-instability which contributes to the acquisition of mutations that cause loss of tumor-suppressor function. The p53 tumor-suppressor gene is the most frequently mutant gene in human cancer. In colorectal cancer cells missense p53 mutations and allelic deletion on chromosomal locus 17p13.1 are found with very high frequency. One of biological roles of p53 gene is to ensure that, in response to genotoxic damage, cells arrest in G1 and attempt to repair their DNA before it is replicated. In addition, p53 is required for apoptosis in response to severe DNA damage, included the damage induced by chemotherapeutics drugs and ionizing radiation. The loss of p53 function results in genomic instability and has been implicated in the evolution of normal cells into cancer cells.