The pathomorphologist's role in the era of personalised therapy regarding the case of colorectal tumours

Abstract

Colorectal cancer is one of the most common epithelial tumours amongst humans. Effective treatment requires a multidisciplinary approach and in some cases target therapy. In order to introduce treatment, both the clinical stage and pathomorphological diagnosis have to be taken into account. An analysis of the microscopic appearance as well as immunohistochemical and molecular tests are the basis of proper diagnosis. Biomarkers for diagnosis of colorectal cancer can be divided into two groups. The first one constitutes diagnostic and prognostic markers which are commonly used by pathologists. They are useful in the recognition of morphological and clinical features of tumours. The second group of biomarkers is used additionally and has predictive value. In an era of personalised therapy, the pathomrothologist's role is to assess the prognostic and predictive biomarkers, in order to identify patients who will benefit from molecular targeted therapy. In the case of colorectal cancer mutations of genes: KRAS, NRAS and BRAF are clinically significant. A lack of the aforementioned mutations correlates with a better response to anti-EGRF therapy.