Abstract
The identification of molecular markers with prognostic value in colorectal cancer is a challenging task that is needed to define therapeutic guidelines. Clinical factors are insufficient to identify those patients with stage II at risk of relapse or those patients with stage III at low risk. There is a current effort to define a consensus in molecular subtypes based on expression profiles, which are characterized by a distinctive prognostic outcome. Also several gene expression signatures based on individual genes have been proposed to predict prognosis, but they show low consistency and reproducibility. Slattery et al. describe a pathway-based approach to analyze gene expression differences between normal and colon cancer tissues. The most interesting finding is that having more deregulated pathways is associated with good prognosis. If these findings are properly validated, new insights into the mechanisms of colon carcinogenesis may be revealed.Please see related article: http://dx.doi.org/10.1186/s12916-015-0292-9.
Highlights
Colorectal cancer (CRC) is a frequently occurring disease with high mortality in which prognosis is dramatically dependent on stage at diagnosis
Multiple efforts have been devoted to characterize the complex molecular landscape of CRC, aiming to identify key genes involved in cancer development and prognosis [2]
Similar pathway-oriented approaches have been described to be more useful than those based on expression of individual genes [8] and reported to be informative about prognosis in breast cancer [9]
Summary
Colorectal cancer (CRC) is a frequently occurring disease with high mortality in which prognosis is dramatically dependent on stage at diagnosis. Survival among cancer patients with increased differentially expressed pathways Slattery et al [7] describe in BMC Medicine a pathwaybased approach to analyze whole genome expression changes in colon cancer tissues when compared to normal adjacent tissue samples. The study initially compared RNAseq expression data from 175 colon tumors with their paired adjacent normal mucosa.
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