Metastasis-associated Factors Facilitating the Progression of Colorectal Cancer

Tumor metastasis remains the principal cause of treatment failure and poor prognosis in patients withcolorectal cancer. It is a multistage process which includes proteolysis, motility and migration of cells, proliferationin a new site, and neoangiogenesis. A crucial step in the process of intra- and extra-vasation is the activation ofproteolytic enzymes capable of degrading the extracellular matrix (ECM). In this stage, urokinase plasminogenactivator receptor (uPAR) and matrix metalloproteinases (MMPs) are necessary. Micrometastases need thepresence of growth factor and vascular growth factor so that they can form macrometastasis. In addition,cell adhesion molecules (CAMs) and guanine nucleotide exchange factors (GEFs) play important roles in theprogression of colorectal cancer and metastatic migration. Further elucidation of the mechanisms of how thesemolecules contribute will aid in the identification of diagnostic and prognostic markers as well as therapeutictargets for patients with colorectal metastasis.