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World J Gastroenterol. Apr 14, 2014; 20(14): 3847-3857
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.3847
Current and future molecular diagnostics in colorectal cancer and colorectal adenoma
Andy Hin-Fung Tsang, Ka-Ho Cheng, Apple Siu-Ping Wong, Simon Siu-Man Ng, Brigette Buig-Yue Ma, Charles Ming-Lok Chan, Nancy Bo-Yin Tsui, Lawrence Wing-Chi Chan, Benjamin Yat-Ming Yung, Sze-Chuen Cesar Wong
Andy Hin-Fung Tsang, Ka-Ho Cheng, Apple Siu-Ping Wong, Nancy Bo-Yin Tsui, Lawrence Wing-Chi Chan, Benjamin Yat-Ming Yung, Sze-Chuen Cesar Wong, Department of Health Technology and Informatics, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
Simon Siu-Man Ng, Department of Surgery, Prince of Wales Hospital, Hong Kong, China
Brigette Buig-Yue Ma, Charles Ming-Lok Chan, Sze-Chuen Cesar Wong, State Key Laboratory in Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
Author contributions: Tsang AHF, Cheng KH and Wong ASP contributed equally to this work; Tsang AHF, Cheng KH, Wong ASP and Wong SCC wrote the paper; Ng SSM, Ma BBY, Chan CML, Tsui NBY, Chan LWC, Yung BYM and Wong SCC reviewed and gave evaluable comments to the paper.
Correspondence to: Sze-Chuen Cesar Wong, Associate Professor, Department of Health Technology and Informatics, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, No. 11 Yucai Road, Kowloon, Hong Kong, China. cesar.wong@polyu.edu.hk
Telephone: +86-852-34008584 Fax: +86-852-23624365
Received: October 11, 2013
Revised: January 10, 2014
Accepted: February 26, 2014
Published online: April 14, 2014
Abstract

Colorectal cancer (CRC) is one of the most prevalent cancers in developed countries. On the other hand, CRC is also one of the most curable cancers if it is detected in early stages through regular colonoscopy or sigmoidoscopy. Since CRC develops slowly from precancerous lesions, early detection can reduce both the incidence and mortality of the disease. Fecal occult blood test is a widely used non-invasive screening tool for CRC. Although fecal occult blood test is simple and cost-effective in screening CRC, there is room for improvement in terms of the accuracy of the test. Genetic dysregulations have been found to play an important role in CRC development. With better understanding of the molecular basis of CRC, there is a growing expectation on the development of diagnostic tests based on more sensitive and specific molecular markers and those tests may provide a breakthrough to the limitations of current screening tests for CRC. In this review, the molecular basis of CRC development, the characteristics and applications of different non-invasive molecular biomarkers, as well as the technologies available for the detection were discussed. This review intended to provide a summary on the current and future molecular diagnostics in CRC and its pre-malignant state, colorectal adenoma.

Keywords: Colorectal cancer, Colorectal adenoma, Molecular diagnostics, Fecal occult blood test, Non-invasive

Core tip: In this review, the molecular basis of colorectal cancer (CRC) development, the characteristics and applications of different non-invasive molecular biomarkers, as well as the technologies available for the detection were discussed. This review intended to provide a summary on the current and future molecular diagnostics in CRC and its pre-malignant state, colorectal adenoma.