J.Jpn. Surg. Soc.. 103(6): 468-471, 2002

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Feature topic

RECENT ADVANCES IN THE DIAGNOSIS AND TREATMENT OF COLORECTAL CANCERS

We review recent developments in the diagnosis and treatment of colorectal cancer. ln diagnosis, the detection of the APC gene mutation in stool samples has had a strong impact because of its practical usage for mass screening. Several reports have indicated that the molecular detection of a very small number of cancer cells in the peripheral blood, bone marrow, or lymph nodes yields adequate information on recurrent disease. Several new markers were reported as a significant indicators of cancer development, invasion, or metastasis.
In treatment, determination of microsatellite instability may be useful to select good candidates for 5- fluorouracil-based chemotherapy. New molecular targets have been reported, including epidermal growth factor receptor inhibitor, matrix metalloproteinase inhibitors, etc. Gene therapy with p53 or FHIT had undergone successful clinical trials. Tumor-specific immunotherapy with dendritic cell vaccination has also been achieved.
In conclusion, many efforts to overcome colorectal cancer will soon open new therapeutic windows.

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