Molecular characterization of colorectal neoplasia in translational research

Objective.-To present recent advances in the use of molecular markers in di agnosis, in prognosis, in early detection, in novel therapies, and in under standing the molecular pathogenesis of colorectal neoplasia. Data and Literature Sources.-A review of studies of molecular markers in co lorectal neoplasia, published in English and available on MEDLINE and BioMe dnet, indicates that molecular markers are being increasingly studied to pr edict clinical outcomes in patients with colorectal adenocarcinoma (CRC). W e have used this resource, together with our published and unpublished obse rvations at the University of Alabama at Birmingham, to provide an overview of translational research related to molecular markers in colorectal: neop lasia. Conclusions.-Currently, the prognosis of patients with CRC is predicted pri marily on the basis of clinicopathologic staging; however, pathologists and oncology surgeons have recently begun to investigate the use of molecular markers to diagnose and/or understand the progression of CRC. In recent yea rs, much has been learned about the molecular events responsible for the de velopment of CRC. Also, several studies have reported the implication of so me molecular markers in metastasis and tumor aggression and their usefulnes s in predicting clinical outcome. in this article, we discuss the use of sp ecific molecular markers, including tumor-associated glycoprotein 72 (TAG-7 2), carcinoembryonic antigen (CEA), and oncofetal tumor antigens (Lewis X a nd Y) in diagnosis and as targets for novel therapies, as well as the pheno typic expression of bcl-2, mucin antigens (MUC1 and MUC2), and nuclear accu mulation of p53 in predicting the clinical outcome of patients with CRC. We also review the ways in which molecular markers may aid the early detectio n of colorectal neoplasia and promote our understanding of the earliest cha nges in colorectal neoplasia.