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Pre‐tumour clones, periodic selection and clonal interference in the origin and progression of gastrointestinal cancer: potential for biomarker development
Author(s) -
Baker AnnMarie,
Graham Trevor A,
Wright Nicholas A
Publication year - 2013
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/path.4157
Subject(s) - gastrointestinal tract , dysplasia , biology , cancer , gastrointestinal cancer , biomarker , somatic evolution in cancer , phenotype , pathology , colorectal cancer , genetics , medicine , gene , biochemistry
Classically, the risk of cancer progression in premalignant conditions of the gastrointestinal tract is assessed by examining the degree of histological dysplasia. However, there are many putative pro‐cancer genetic changes that have occurred in histologically normal tissue well before the onset of dysplasia. Here we summarize the evidence for such pre‐tumour clones and the existing technology that can be used to locate these clones and characterize them at the genetic level. We also discuss the mechanisms by which pre‐tumour clones may spread through large areas of normal tissue, and highlight emerging theories on how multiple clones compete and interact within the gastrointestinal mucosa. It is important to gain an understanding of these processes, as it is envisaged that certain pre‐tumour changes may be powerful predictive markers, with the potential to identify patients at high risk of developing cancer at a much earlier stage.