Xu DG, Tan J. Interplay of genetic and clinical factors in cancer-associated thrombosis: Deciphering the prothrombotic landscape of colorectal cancer. World J Gastroenterol 2025; 31(14): 103901 [DOI: 10.3748/wjg.v31.i14.103901]
Corresponding Author of This Article
Jing Tan, PhD, Professor, Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, No. 245 Renmin East Road, Panlong District, Kunming 650051, Yunnan Province, China. jingtan0915@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 14, 2025; 31(14): 103901 Published online Apr 14, 2025. doi: 10.3748/wjg.v31.i14.103901
Interplay of genetic and clinical factors in cancer-associated thrombosis: Deciphering the prothrombotic landscape of colorectal cancer
Duo-Gang Xu, Jing Tan
Duo-Gang Xu, Jing Tan, Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, Kunming 650051, Yunnan Province, China
Duo-Gang Xu, Jing Tan, Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming 650051, Yunnan Province, China
Author contributions: Xu DG contributed significantly to the conceptualization, writing and design of the article; Tan J contributed to the drafting of the article and provided critical revisions of significant intellectual content; all authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Tan, PhD, Professor, Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, No. 245 Renmin East Road, Panlong District, Kunming 650051, Yunnan Province, China. jingtan0915@163.com
Received: December 4, 2024 Revised: March 3, 2025 Accepted: March 25, 2025 Published online: April 14, 2025 Processing time: 128 Days and 12.8 Hours
Abstract
Colorectal cancer (CRC), the third most prevalent cancer globally, exhibits a notable association with venous thromboembolism (VTE), significantly impacting patient morbidity and mortality. We delve into the complex pathogenesis of cancer-associated thrombosis (CAT) in CRC, highlighting the interplay of clinical risk factors and tumor-specific mechanisms. Our comprehensive review synthesizes the current understanding of CRC’s pro-thrombotic tendencies, examining both general clinical factors (e.g., age, gender, obesity, prior VTE history) and tumor-specific aspects (e.g., tumor location, stage, targeted therapies). Key findings illustrate how CRC cells themselves actively contribute to coagulation cascade activation through various procoagulant elements such as tissue factor, cancer procoagulant, and extracellular vesicles. We also explore how CRC influences host cells to adopt a procoagulant phenotype, thereby exacerbating thrombotic risks. This review underscores the role of genetic mutations in CRC (e.g.,KRAS, p53) in modulating coagulation-related protein expression and thrombosis risks. An in-depth understanding of the genetic landscape specific to CRC subtypes is essential for developing targeted anticoagulation strategies and could significantly advance thrombosis prevention while improving the overall management of patients with CRC. This highlights the urgent need for precision in addressing CAT within clinical settings.
Core Tip: This comprehensive review examines the complex interplay between genetic and clinical factors in colorectal cancer (CRC)-associated thrombosis. It highlights how tumor-specific mechanisms, such as tissue factor and cancer procoagulant, actively contribute to the coagulation cascade, alongside clinical risk factors like age, gender, and obesity. By integrating both tumor biology and patient-specific characteristics, this study provides crucial insights into the prothrombotic tendencies of CRC, offering valuable perspectives for personalized therapies and improving patient management in CRC-associated venous thromboembolism.
