Molecular Heterogeneity in Colorectal Cancer: Insights from Genetic Profiling

Mohd Younis, P Sujeetha, T Sangeetha, M Kaviya, K Bharathi, A Vijaya Anand


The high heterogeneity has become apparent in metastatic colorectal cancer (CRC) and the solitary leading causes of cancer mortality worldwide. Tumor from benign to malignancies derives by gradual and progressive genetic alterations develop into a collection of neoplastic diseases. The parameters are assessed to indicate the extent and prognosis of the disease such as tumor node metastasis stage, tumor grade, microsatellite status, lymphovascular invasion. It is investigated KRAS mutation status in a metastatic to predict the response to anti-epidermal growth factor.  CRC has been described that have prognostic and therapeutic relevance at a distinct molecular level. In the present study, the researcher recruited 65 CRC patients with different stages of the tumor at the right-sided colon, left-sided colon and rectum. We have also recognized left-sided was more complex than right sided CRC patents. In CRC, it has revealed the major differences in the characterization of inflammatory infiltrations and cells location in tumor types. All the patients were stratified into different prognostic and therapeutic groups with the help of these parameters. Though, CRC show intra-tumor heterogeneity due to not clear-cut stratification. However, several CRC patients with single tumor mutations show differences in their mutational status, morphology, inflammatory infiltrate and gene expression. In conclusion, the primary focus on the concept of molecular heterogeneity their metastases and clinical implication in CRC.



Colorectal Cancer, Genetic alternations, Heterogeneity, Tumor node metastasis

Full Text:



Alam MN, Almoyad M, Huq F. Polyphenols in Colorectal Cancer: Current State of Knowledge including Clinical Trials and Molecular Mechanism of Action. Biomed Research International. 2018;2018: 1-29.

Al‑Saeed EF, Tunio MA, Al-Obaid O, Abdulla M, Al-Anazi A, Al-Shanifi J, et al. Correlation of Pretreatment Hemoglobin and Platelet Counts with Clinicopathological Features in Colorectal Cancer in Saudi Population. The Saudi Journal of Gastroenterology. 2014;20(2): 134-138.

Amersi F, Agustin M, Ko CY. Colorectal cancer: epidemiology, risk factors, and health services. Clinics in Colon and Rectal Surgery. 2005;18(3): 133-140.

Castillo-Pérez JJ. Thrombocytosis as a predictor of distant recurrence in patients with rectal cancer. Archives of Medical Research. 2013;44(1): 77-78.

Cuyle PJ, Prenen H. Current and future biomarkers in the treatment of colorectal cancer. Acta Clinica Belgica. 2017;72(2): 103-115.

Dagogo-Jack I, Shaw AT. Tumour heterogeneity and resistance to cancer therapies. Nature reviews Clinical oncology. 2018;15(2): 81-87.

Fleming M, Ravula S, Tatishchev SF, Wang HL. Colorectal carcinoma: Pathologic aspects. Journal of Gastrointestinal Oncology. 2012;3(3): 153-173.

Hugen N, Brown G, Glynne-Jones R, de Wilt JH, Nagtegaal ID. Advances in the care of patients with mucinous colorectal cancer. Nature Reviews Clinical Oncology. 2016;13(6): 361-369.

Kim JW, Jeon YJ, Jang MJ, Kim JO, Chong SY. Association between folate metabolism-related polymorphisms and colorectal cancer risk. Molecular and Clinical Oncology. 2015;3(3): 639-648.

Lee YJ, Lee HR, Nam CM, Hwang UK, Jee SH. White Blood Cell Count and the Risk of Colon Cancer. Yonsei Medical Journal. 2006;47(5): 646-656.

Lynch HT, Chapelle A. Hereditary colorectal cancer. New England Journal of Medicine. 2003;348(10): 919-932.

Malenica M, Prnjavorac B, Bego T, Dujic T, Semiz S, Skrbo S. Effect of Cigarette Smoking on Haematological Parameters in Healthy Population. Medical Archives. 2017;71(2): 132-136.

Mekenkamp LJ, Tol J, Dijkstra JR, de Krijger I, Vink-Börger ME, van Vliet S, et al. Beyond KRAS mutation status: influence of KRAS copy number status and microRNAs on clinical outcome to cetuximab in metastatic colorectal cancer patients. BMC Cancer. 2012;12(1): 292.

Mohd Y, Balasubramanian B, Meyyazhagan A, Bhotla HK, Shanmugam SK, Kumar MK, Pappusamy M, Alagamuthu KK, Keshavarao S, Arumugam VA. Extricating the Association Between the Prognostic Factors of Colorectal Cancer. Journal of Gastrointestinal Cancer. 2020: 13:1-7.

Puppa G, Sonzogni A, Colombari R, Pelosi G. TNM staging system of colorectal carcinoma: a critical appraisal of challenging issues. Archives of Pathology & Laboratory Medicine. 2010;134(6): 837-852.

Roth AD, Tejpar S, Delorenzi M, Yan P, Fiocca R, Klingbiel D, et al. Prognostic Role of KRAS and BRAF in Stage II and III Resected Colon Cancer: Results of the Translational Study on the PETACC-3, EORTC 40993, SAKK 60-00 Trial. Journal of Clinical Oncology. 2010;28(3): 466-474.

Steele SR, Park GE, Johnson EK, Martin MJ, Stojadinovic A, Maykel JA, et al. The impact of age on colorectal cancer incidence, treatment, and outcomes in an equal-access health care system. Diseases of Colon and Rectum. 2014;57(3): 303-310.

Sudarshan V, Hussain N, Gahine R, Mourya J. Colorectal cancer in young adults in a tertiary care hospital in Chhattisgarh, Raipur. Indian Journal of Cancer. 2013;50(4): 337-340.

Tan C, Du X. KRAS mutation testing in metastatic colorectal cancer. World Journal of Gastroenterology. 2012;18(37): 5171-5180.

Walter V, Jansen L, Hoffmeister M, Ulrich A, Chang-Claude J, Brenner H. Smoking and survival of colorectal cancer patients: population-based study from Germany. International Journal of Cancer. 2015;137(6): 1433-1445.

Wang C, Li P, Xuan J, Zhu C, Liu J, Shan L, et al. Cholesterol enhances colorectal cancer progression via ROS elevation and MAPK signaling pathway activation. Cellular Physiology and Biochemistry. 2017;42(2): 729-742.

Younis M, Arun M, Iqbal J, Kumar M, Arun S, Cacabelos R, et al. Analysis of Genetic Alterations in Colorectal Cancer (CRC) Patients in South Indian Population. International Journal of Human Genetics. 2018;18(3): 210-218.

Zellmer VR, Zhang S. Evolving concepts of tumor heterogeneity. Cell & bioscience. 2014;4(1): 1-8.


  • There are currently no refbacks.

Copyright (c) 2021 Mohd Younis, P Sujeetha, T Sangeetha, M Kaviya, K Bharathi, A Vijaya Anand

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.