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Resumen
El cáncer colorrectal (CCR) es la cuarta causa de mortalidad por cáncer en Colombia y en el mundo, en ambos sexos; por esta razón, es considerado un problema de salud pública. El CCR es altamente heterogéneo en su fenotipo y genotipo, lo que está en relación con las diferentes vías de carcinogénesis descritas que implican diferentes mecanismos de progresión y agresividad de la enfermedad. Las vías clásicas, supresora y mutadora, se caracterizan por una serie de alteraciones genéticas relacionadas con los cambios fenotípicos de la progresión morfológica en la secuencia adenoma-carcinoma. Las vías alternas, originadas por mutaciones en los genes, BRAF y KRAS, se relacionan con la progresión de pólipo aserrado a carcinoma. Conocer estas vías es muy importante para comprender la enfermedad de manera integral y profundizar en el estudio de sus mecanismos de control, que incluyen: diagnóstico temprano, tratamiento y seguimiento.
Palabras clave:
Focos de criptas aberrantes
neoplasias colorrectales
pólipos del colon
inestabilidad cromosómica
inestabilidad de microsatélites
Abstract
Colorectal cancer (CRC) is ranked fourth among causes of cancer mortality in Colombia and in the world, for both genders; it is therefore regarded as a public health issue. CRC's phenotype and genotype are highly heterogeneous, a fact related to the various carcinogenic pathways described, and which is also implicated in the different progression mechanisms and the aggressiveness of the disease. The classic pathways, suppressive and mutable, are characterized by a series of genetic alterations related to phenotype changes in the morphologic progression of the adenoma-carcinoma sequence. The alternate pathways, originated by BRAF and KRAS gene mutations, are linked to the serrated polyp progression to carcinoma. Knowledge of these pathways is very important in achieving a fuller understanding of the disease and for broadening the study of mechanisms for its control; these include: early diagnosis, treatment and follow-up.
Key words:
Aberrant crypt foci
colorectal neoplasms
colonic polyps
chromosomal instability
microsatellite instability
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