Роль стволовых клеток в канцерогенезе толстой кишки

Значительную роль в развитии и прогрессировании колоректального рака играют так называемые стволовые клетки опухоли (cancer stem cells, CSC), которые способны к самоподдержанию и мультипотентной дифференцировке. CSC могут образовываться из мутантных стволовых клеток или путем дедифференцировки эпителиальных клеток крипты. В последнее время большое внимание уделяется изучению роли CSC в раке толстой кишки, но крайне мало публикаций относительно их экспрессии в полипах толстой кишки. По классификации Всемирной организации здравоохранения (2010) в группу предопухолевых поражений толстой кишки помимо классических тубулярных, ворсинчатых и тубулоборсинчатых аденом отнесены так называемые зубчатые образования, включающие гиперпластический полип, зубчатую аденому на широком основании и традиционную зубчатую аденому. Большое количество публикаций посвящено вновь выделенным категориям CSC, но полного понимания процессов, вовлеченных в формирование полипов и их прогрессию в рак толстой кишки, до сих пор нет. Идентификация CSC в полипах толстой кишки позволит оценить их потенциал злокачественности, проводить адекватную терапию, определить объем операции и дальнейшую тактику лечения. Это в свою очередь будет способствовать раннему обнаружению и предотвращению рака. Выявление CSC, оценка их локализации и распределения в тубулярной аденоме, зубчатой аденоме на широком основании, традиционной зубчатой аденоме и гиперпластическом полипе позволяют оценить потенциал злокачественности и прогноз для каждого полипа. В связи с этим определение маркеров, характерных для CSC толстой кишки, представляется интересным не только с научной, но и с практической точки зрения.

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