943 Beyond the Adenoma Carcinoma Sequence

Abstract Introduction Looking beyond the adenoma carcinoma sequence researchers have discovered alternate morpho-genetic routes, and tumour biomarkers in colorectal cancer. This has caused a paradigm shift management, resulting improved diagnosis, prevention, delivery of tailored treatment aiming at specific molecular pathways. Aim review summarises Method PubMed, Google Scholar, NLM searches based on aims key words were conducted. Further, academically, clinically relevant made if more information was required. When required, references articles also retrieved. Results The two main theories regarding morphological origins cancer are De-novo origins. underlying genetic models (i) chromosomal instability pathway (CIN), (ii) microsatellite (MSI) (iii) CpG Island methylator phenotype (CIMP) Though unique, pathways communicate with each other. fingerprinting cancers an impact their management consequently through grounding basics essential for those gastrointestinal subspecialties. Conclusions Two morphologically distinct three unique mechanisms been described. There significant interactions between them. Behaviours sporadic inherited cancer, prognosis depend our understanding these availability targeted therapies to assist surgical resection.