From blockage to biology: Unveiling the role of extracellular matrix dynamics in obstructive colorectal cancer pathogenesis

IF 2.9 4区医学 Q2 PATHOLOGY

Pathology, research and practice Pub Date : 2025-04-28 DOI:10.1016/j.prp.2025.155994

Jun Wang , Mian Chen , Guanxin Wei , Falong Zou , Junnan Gu , Yinghao Cao , Shenghe Deng , Kailin Cai

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Abstract

Colorectal cancer obstruction is a common problem with distinct symptomatic clues on CT/MR images even under incomplete conditions. The choice of management in the emergency setting has a significant effect on the prognosis of obstructive and nonobstructive colorectal cancer patients. Previous studies have demonstrated that obstruction in colorectal cancer is associated with significantly poorer outcomes, alongside distinct alterations in the composition of the extracellular matrix. Based on accumulating evidence, it is hypothesized that ECM remodeling plays a pivotal role in the development of colorectal cancer obstruction. This review explores the pathological features of obstructive colorectal cancer, emphasizing extracellular matrix remodeling as a central process. Key mechanisms include tumor-stromal cell interactions, tumor cell aggregation and migration mediated by the peripheral nervous system, vascular and lymphatic remodeling within the tumor microenvironment, and microbiota-mediated regulation of cancer progression. These findings demonstrate that further remodeling of the extracellular matrix may be a molecular biological feature of obstructive colorectal cancer with poor prognosis.

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从阻塞到生物学：揭示细胞外基质动力学在梗阻性结直肠癌发病机制中的作用

结直肠癌梗阻是一个常见的问题，即使在不完全条件下，CT/MR图像上也有明显的症状线索。急诊处理方式的选择对梗阻性和非梗阻性结直肠癌患者的预后有显著影响。先前的研究表明，结直肠癌梗阻与预后明显较差相关，同时细胞外基质成分也发生明显改变。根据积累的证据，我们假设ECM重塑在结直肠癌梗阻的发生发展中起关键作用。本文综述梗阻性结直肠癌的病理特征，强调细胞外基质重塑是其中心过程。关键机制包括肿瘤-基质细胞相互作用、周围神经系统介导的肿瘤细胞聚集和迁移、肿瘤微环境内血管和淋巴重塑以及微生物群介导的癌症进展调节。这些发现表明，细胞外基质的进一步重塑可能是预后不良的梗阻性结直肠癌的分子生物学特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pathology, research and practice 医学-病理学

CiteScore

5.00

自引率

3.60%

发文量

405

审稿时长

24 days

期刊介绍： Pathology, Research and Practice provides accessible coverage of the most recent developments across the entire field of pathology: Reviews focus on recent progress in pathology, while Comments look at interesting current problems and at hypotheses for future developments in pathology. Original Papers present novel findings on all aspects of general, anatomic and molecular pathology. Rapid Communications inform readers on preliminary findings that may be relevant for further studies and need to be communicated quickly. Teaching Cases look at new aspects or special diagnostic problems of diseases and at case reports relevant for the pathologist''s practice.