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Erschienen in: Wiener klinisches Magazin 4/2015

01.09.2015 | Pathologie

Molekulare Pathologie des kolorektalen Karzinoms

verfasst von: Dr. Dr. Jens H.L. Neumann, Andreas Jung, Thomas Kirchner

Erschienen in: Wiener klinisches Magazin | Ausgabe 4/2015

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Zusammenfassung

In den letzten Jahren konnten beim kolorektalen Karzinom (KRK) mehrere prädiktive und prognostische Biomarker etabliert werden. Der RAS-Mutationsstatus ist ein in der täglichen Routine breit angewendeter prädiktiver Biomarker für eine Therapie mit Epidermal-Growth-Factor-Receptor(EGFR)-Inhibitoren. Eine BRAF-Mutation besitzt in diesem Kontext hingegen keine prädiktive Aussagekraft. Der Nachweis einer hochgradigen Mikrosatelliteninstabilität (MSI-H) ist prädiktiv für das Ansprechen auf eine 5-Fluoruracil-Monotherapie. Prognostische Biomarker beim KRK sind der MSI-Status sowie der Nachweis einer BRAF-Mutation. Nach der aktuellen WHO-Klassifikation werden wenig und undifferenzierte KRK sowie MSI-assoziierte morphologische Sonderformen anhand des MSI-Status molekular graduiert. Der Nachweis einer BRAF-Mutation vor dem Hintergrund einer Mikrosatellitenstabilität (MSS) ist mit einer sehr schlechten Prognose assoziiert und stellt somit den aggressivsten molekularen Subtyp des KRK dar. Für die Abklärung eines begründeten Verdachts auf eine Assoziation eines KRK mit einem hereditären nichtpolipösen kolorektalen Karzinom (HNPCC-Syndrom) wird aktuell eine immunhistochemische und molekularpathologische Stufendiagnostik empfohlen.
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Metadaten
Titel
Molekulare Pathologie des kolorektalen Karzinoms
verfasst von
Dr. Dr. Jens H.L. Neumann
Andreas Jung
Thomas Kirchner
Publikationsdatum
01.09.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinisches Magazin / Ausgabe 4/2015
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI
https://doi.org/10.1007/s00740-015-0061-6

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