Hereditary nonpolyposis colorectal carcinoma (HNPCC) consist of two main types. Lynch I is autosomal dominant while Lynch II is associated with ovary, breast, stomach cancers. It is suggested that colorectal cancer develops from a progression from benign adenomas which develop genetic mutations or loss of heterozygosity (LOC). Various genes have been investigated as participants in that progression (Table 12.2).

The starting point is a mutation in the APC gene, a tumor suppressor gene. Recent research suggests a link between loss of downregulation of beta-catenin as the central mediator in this process. The DCC gene is also involved in the process. Patients with loss of DCC have a poorer prognosis compared to those patients with an intact gene.

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