Colorectal cancer: genetics of development and metastasis

J Gastroenterol. 2006 Mar;41(3):185-92. doi: 10.1007/s00535-006-1801-6.


It has been well documented that there are two major pathways in colorectal carcinogenesis. One is the chromosomal instability pathway (adenoma-carcinoma sequence), which is characterized by allelic losses on chromosome 5q (APC), 17p (p53), and 18q (DCC/SMAD4), and the other is a pathway that involves microsatellite instability. Recent progress in molecular biology, however, has shown that colorectal carcinogenesis is not necessarily clearly divided into these two pathways, but is in fact more complicated. Other routes, including the transforming growth factor-beta/SMAD pathway, the serrated pathway, and the epigenetic pathway, have been reported. Cross talk among these pathways has also been reported. In the invasion and metastasis steps of colorectal cancers, many more genes have now been identified as being involved in proteolysis, adhesion, angiogenesis, and cell growth. Recently accumulated evidence indicates that colorectal cancer is a genetically heterogeneous and complicated disease.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / genetics*
  • Carcinoma / genetics*
  • Cell Transformation, Neoplastic / genetics*
  • Chromosomal Instability
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / pathology
  • Epigenesis, Genetic
  • Gene Expression Regulation, Neoplastic
  • Genes, Tumor Suppressor
  • Genes, ras
  • Genetic Predisposition to Disease
  • Humans
  • Microsatellite Instability
  • Signal Transduction / genetics
  • Smad4 Protein / genetics
  • Transforming Growth Factor beta / genetics
  • Tumor Suppressor Proteins / genetics


  • Smad4 Protein
  • Transforming Growth Factor beta
  • Tumor Suppressor Proteins