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Fig. 1 | Applied Cancer Research

Fig. 1

From: Current applications of molecular pathology in colorectal carcinoma

Fig. 1

Three major pathways leading to colorectal cancers. (1) Conventional adenoma-carcinoma sequence with oncogene (e.g. KRAS) activation and tumor suppressor (e.g. APC, SMAD4 and TP53) inactivation, resulting in microsatellite stable (MSS) cancers; (2) Microsatellite instability (MSI) pathway with mismatch repair (MMR) protein deficiency in patients with Lynch syndrome, resulting in MSI-high (MSI-H) cancers; (3) Serrated pathway with CpG island methylation phenotype, resulting in either MSI-H cancers if methylation occurs in MLH1 promoter or MSS cancers if methylation occurs in tumor suppressor genes. HGD: high-grade dysplasia; LGD: low-grade dysplasia; SSA: sessile serrated adenoma

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