大腸癌の発育・進展の分子基盤—adenoma carcinoma sequence，de novo，serrated pathway，dysplasia-carcinoma sequenceを含めて

The Molecular Basis of Colorectal Cancer Development and Progression（Including the Adenoma-carcinoma Sequence, de novo Pathway, Serrated Pathway, and Dysplasia-carcinoma Sequence）

要旨●大腸癌の発癌経路にはadenoma-carcinoma sequence，serrated pathway，de novo発癌，dysplasia-carcinoma sequenceがあり，進行大腸癌においてはこれらとは別に，複数の分子分類が提唱されてきた．これらの発癌経路や分子分類ではそれぞれに臨床病理学的特徴や経緯を有しており，いまだにその分類は発展途上である．本稿では大腸癌の発癌と分子分類に焦点を当て，各発癌経路に関連する分子を概説した後にThe Cancer Genome Atlasやコンセンサス分子サブタイプ分類（CMS）といった分子分類の概要を紹介する．

　There are several known pathways of colorectal carcinogenesis, including the adenoma-carcinoma sequence, serrated pathway, de novo carcinogenesis, and dysplasia-carcinoma sequence. In addition to these, multiple molecular classifications have been proposed for advanced colorectal cancer. These pathways and classifications have distinctive clinicopathological features and developmental backgrounds, and their classification is evolving. In this review, we focus on the molecular mechanisms and classifications of colorectal cancer, first outlining the key molecular alterations associated with each carcinogenic pathway, and then summarizing representative molecular classifications such as The Cancer Genome Atlas and the Consensus Molecular Subtypes.