Molekulare Pathologie des kolorektalen Karzinoms
作者： Jens H.L. Neumann , Andreas Jung , Thomas Kirchner
DOI: 10.1007/S00740-015-0061-6
关键词: Medicine public health 、 Gynecology 、 Medicine
摘要: In den letzten Jahren konnten beim kolorektalen Karzinom (KRK) mehrere pradiktive und prognostische Biomarker etabliert werden. Der RAS-Mutationsstatus ist ein in der taglichen Routine breit angewendeter pradiktiver fur eine Therapie mit Epidermal-Growth-Factor-Receptor(EGFR)-Inhibitoren. Eine BRAF-Mutation besitzt diesem Kontext hingegen keine Aussagekraft. Nachweis einer hochgradigen Mikrosatelliteninstabilitat (MSI-H) pradiktiv das Ansprechen auf 5-Fluoruracil-Monotherapie. Prognostische KRK sind MSI-Status sowie BRAF-Mutation. Nach aktuellen WHO-Klassifikation werden wenig undifferenzierte MSI-assoziierte morphologische Sonderformen anhand des molekular graduiert. vor dem Hintergrund Mikrosatellitenstabilitat (MSS) sehr schlechten Prognose assoziiert stellt somit aggressivsten molekularen Subtyp dar. Fur die Abklarung eines begrundeten Verdachts Assoziation einem hereditaren nichtpoliposen (HNPCC-Syndrom) wird aktuell immunhistochemische molekularpathologische Stufendiagnostik empfohlen.
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