Biology of large bowel cancer. Present status and research frontiers

Abstract

Man and laboratory rodents exposed to chemical carcinogens both show similar changes in growth characteristics of colonic epithelial cells during neoplastic transformation. Progressive phases of abnormal cell development appear in colonic epithelial ceIIs which gain a n increased abiIity to proliferate and accumulate in the mucosa. These phases in the expression of neoplastic transformation of colonic cells are best defined in the dominant inherited disease of man as adenomatosis of the colon and rectum. Individuals with inherited adeno-matosis and those in lesser risk categories can be classified by cell phenotype based on changes in the proliferation and maturation of colonic and other cells. These classifications are leading to new predictive indices which identify heightened degrees of susceptibility of individuals who are at increased risk for colon cancer, and the stage of development of their disease. T h e indices also are being used to study the contribution of specific elements in the environment that modify or accelerate the progression of disease.