International Journal of Molecular Medical Science, 2024, Vol.14, No.5, 293-304 http://medscipublisher.com/index.php/ijmms 294 mutations, epigenetic alterations, and environmental factors. Key genetic mutations often include alterations in the APC, KRAS, and TP53 genes (Figure 1), which drive the transformation of normal colonic epithelium into adenomatous polyps and eventually invasive cancer. Additionally, the tumor microenvironment (TME) plays a crucial role in the progression and metastasis of colon cancer by influencing tumor cell behavior and response to therapy (Wei et al., 2020; Price et al., 2022). Figure 1 Adding spatial information to tumor microenvironment study (Created with BioRender.com) Imagine caption: “Colon Cancer Pathogenesis” refers to elucidating the process by which normal colon cells gradually transform into cancer cells through various genetic mutations. “Tumour Microenvironment” refers to the study of spatial architecture of tumours and their interface with other cell subtypes in their environment. “Clinical Implications of ST” aim to summarize the current applications of spatial transcriptomics in the clinical, including the identification and validation of biomarkers through data analysis, the development of precision medicine and personalized treatment strategies, the construction of predictive models for treatment response, and feture clinical translation 2.2 Components of the tumor microenvironment 2.2.1 Cellular components The TME of colon cancer is composed of a diverse array of cellular components, including cancer cells, immune cells, fibroblasts, endothelial cells, and other stromal cells (Figure 1). Immune cells, such as T cells, macrophages, and dendritic cells, infiltrate the tumor and can either promote or inhibit tumor growth depending on their activation state and the cytokine milieu. Fibroblasts, particularly cancer-associated fibroblasts (CAFs), secrete extracellular matrix (ECM) components and growth factors that support tumor growth and angiogenesis. Endothelial cells form the blood vessels that supply the tumor with nutrients and oxygen, facilitating tumor growth and metastasis (Romero-López et al., 2017; Wei et al., 2020; Price et al., 2022). 2.2.2 Extracellular matrix and signaling molecules The ECM is a critical component of the TME, providing structural support and biochemical signals that influence tumor cell behavior. The ECM is composed of various proteins, including collagen, elastin, laminin, and fibronectin, as well as proteoglycans and glycoproteins. These components are dynamically remodeled during cancer progression, leading to changes in tissue stiffness and the creation of a pro-tumorigenic environment. Signaling molecules such as cytokines, chemokines, and growth factors are also abundant in the TME and play key roles in modulating immune responses, promoting angiogenesis, and facilitating tumor cell invasion and metastasis (Romero-López et al., 2017; Kim et al., 2021; Lu et al., 2012).
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