Approximately 40–50% of all colorectal patients relapse in the form of metastasis. In the last three years, several molecular classifications have been proposed to identify colorectal cancer patients at risk of relapse. In an article published online on February 23, 2015 in Nature Genetics, scientists headed by ICREA (Institutio Catalana de Recerca Estudis Avancats) researcher Dr. Eduard Batlle at the Institute for Research in Biomedicine in Barcelona (IRB Barcelona) explain why these classifications work and reveal, in fact, that they can be simplified and improved by looking exclusively at the genes that are expressed in the tissue around the tumor, known as the stroma or tumor microenvironment. “We have re-evaluated the classifications under our perspective and confirmed that colon cancer relapse occurs in patients in which tumor cells have the capacity to disrupt the tissue surrounding the tumor,” explains Dr. Batlle, Head of the Colorectal Cancer Laboratory at IRB Barcelona. The team of scientists examined the genetic profiles of approximately 1,000 tumors from patients all over the world. “The conclusion is indisputable. The key to the classifications lies in whether the stroma of the tumor is altered or not and it is this property that confers malignancy to colon tumors. Patients with unaltered stroma are essentially cured after surgery.” The Nature Genetics article is titled “Stromal Gene Expression Defines Poor-Prognosis Subtypes in Colorectal Cancer.” This new approach to addressing different types of colon tumor will soon have a practical application for doctors. On one hand, the scientists demonstrate that tumor cells communicate with the stroma through the hormone TGF-beta and that metastasis could be prevented in these patients by interfering with this communication.
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