Chemoprophylaxis of precancerous lesions in patients who are at a high risk of developing colorectal cancer (Review)

TL;DR

This review discusses the role of β-catenin and other pathways in the progression of precancerous colorectal lesions and explores chemoprophylaxis strategies for high-risk patients.

Contribution

The paper provides a comprehensive analysis of chemoprophylaxis approaches based on endoscopic, morphological, and molecular-genetic findings.

Findings

β-catenin and the PI3K/AKT/mTOR pathway play key roles in the transformation of precancerous lesions into CRC.

Current diagnostic methods include colonoscopy, CT colonography, and stool DNA tests.

Chemoprophylaxis strategies vary depending on test results and molecular-genetic profiles.

Abstract

The diagnostics of colorectal cancer (CRC) and precancerous lesions in the colon is one of the most urgent matters to be considered for the modern protocols of complex examination, recommended for use from the age of 45 years, and including both instrumental and laboratory methods of research: Colonoscopy, CT colonography, flexible sigmoidoscopy, fecal occult blood test, fecal immunohistochemistry test and stool DNA test Nevertheless, the removal of those precancerous lesions does not solve the issue, and, apart from the regular endoscopic monitoring of patients who are at a high risk of developing CRC, the pharmacological treatment of certain key pathogenic mechanisms leading to the development of CRC is required. The present review to discusses the function of β-catenin in the transformation of precancerous colorectal lesions into CRC, when collaborating with PI3K/AKT/mTOR signaling pathway and other mechanisms. The existing methods for the early diagnostics and prevention of discovered anomalies are described and categorized. The analysis of the approaches to chemoprophylaxis of CRC, depending on the results of endoscopic, morphological and molecular-genetic tests, is presented.

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