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Review
. 2018 Jul 21;24(27):2949-2973.
doi: 10.3748/wjg.v24.i27.2949.

MicroRNAs in the prognosis and therapy of colorectal cancer: From bench to bedside

Kenneth Kw To  1 , Christy Ws Tong  2 , Mingxia Wu  2 , William Cs Cho  3
Affiliations
Review

MicroRNAs in the prognosis and therapy of colorectal cancer: From bench to bedside

Kenneth Kw To et al. World J Gastroenterol. .

Abstract

MicroRNAs (miRNAs) are small, single-stranded, noncoding RNAs that can post-transcriptionally regulate the expression of various oncogenes and tumor suppressor genes. Dysregulated expression of many miRNAs have been shown to mediate the signaling pathways critical in the multistep carcinogenesis of colorectal cancer (CRC). MiRNAs are stable and protected from RNase-mediated degradation, thereby enabling its detection in biological fluids and archival tissues for biomarker studies. This review focuses on the role and application of miRNAs in the prognosis and therapy of CRC. While stage II CRC is potentially curable by surgical resection, a significant percentage of stage II CRC patients do develop recurrence. MiRNA biomarkers may be used to stratify such high-risk population for adjuvant chemotherapy to provide better prognoses. Growing evidence also suggests that miRNAs are involved in the metastatic process of CRC. Certain of these miRNAs may thus be used as prognostic biomarkers to identify patients more likely to have micro-metastasis, who could be monitored more closely after surgery and/or given more aggressive adjuvant chemotherapy. Intrinsic and acquired resistance to chemotherapy severely hinders successful chemotherapy in CRC treatment. Predictive miRNA biomarkers for response to chemotherapy may identify patients who will benefit the most from a particular regimen and also spare the patients from unnecessary side effects. Selection of patients to receive the new targeted therapy is becoming possible with the use of predictive miRNA biomarkers. Lastly, forced expression of tumor suppressor miRNA or silencing of oncogenic miRNA in tumors by gene therapy can also be adopted to treat CRC alone or in combination with other chemotherapeutic drugs.

Keywords: Apoptosis; Colorectal cancer; Metastasis; MicroRNA; Multidrug resistance; Prognosis; Recurrence; Risk stratification; Therapeutic target.

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Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest. No financial support.

Figures

Figure 1
Figure 1
MicroRNA dysregulation and colorectal cancer progression. Altered expression of representative miRNAs are shown in different stages of CRC (in bold: Normal epithelium → early adenoma → late adenoma → carcinoma → metastasis). Upregulation or downregulation of miRNAs can affect signaling pathways and propel progression of CRC, leading to angiogenesis, cell invasion, metastasis and inhibition of apoptosis. APC: adenomatous polyposis coli; CRC: Colorectal cancer; KRAS: Kirsten rat sarcoma viral oncogene homolog; TP53: tumor protein p53.
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