Genomic instability in ulcerative colitis: a prerequisite for cancer in the inflammatory colon?
Ulcerative colitis (UC), a chronic and relapsing idiopathic inflammatory disease of the colon, although not associated with an increased mortality compared to the general population, has a substantial morbidity leading to sizable health care costs, as it carries an increased risk for development of colorectal cancer (CRC). The pathophysiology behind this carcinogenic pathway is multifactorial. This review summarizes the major pathogenetic steps from which the inflamed colonic epithelium is transformed to a dysplastic and/or cancerous one. The role of the inflammatory and immune system, the oxidative stress generated as well as the genomic stability observed in UC-associated CRC is presented so as to provide a more spherical view of the tumorigenic process and, if possible, offer new diagnostic approaches for the early detection of CRC.
Medical School, University of Athens, Athens, Greece. ekmektzo@hotmail.com
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Ekmektzoglou
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Samelis
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Karagiannis
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Zografos
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Xanthos
D002471:Cell Transformation, Neoplastic / Q000235:genetics*; D003093:Colitis, Ulcerative / Q000235:genetics* / Q000276:immunology / Q000503:physiopathology; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D042822:Genomic Instability / Q000502:physiology*; D006801:Humans; D011230:Precancerous Conditions / Q000235:genetics / Q000276:immunology