Adenoma-Carcinoma Sequence in Colorectal Cancer : Mnemonic

Adenoma-carcinoma sequence is a stepwise development of normal epithelium to carcinoma due to accumulation of mutations over a number of years leading to activation of oncogenes and loss of tumor suppressor genes. One of the pathways follows adenoma–carcinoma sequence, that is, normal → adenoma → carcinoma. The other is pertaining to the development of de novo cancers, like flat or depressed cancers without adenomatous remnants. 

1. AK-53 (A Swiss rifle similar to AK-47 but not as popular)
2. 5 + 12 = 17 (Chromosomes associated)

AK-53 rifle
AK-53 rifle
AugFC, CC BY 4.0, via Wikimedia Commons

The sequence is as follows:

1. APC tumor suppressor gene mutation (5q): Development of small adenoma

2. KRAS oncogene mutation (12p): Development of large adenoma

3. p-53 tumor suppressor gene mutation (17p): Development of carcinoma

adenoma-carcinoma sequence
Souza RF. A molecular rationale for the how, when and why of colorectal cancer screening. Aliment Pharmacol Ther. 2001 Apr;15(4):451-62. doi: 10.1046/j.1365-2036.2001.00935.x. PMID: 11284773.

This model, as we currently understand it, accounts for most, but not necessarily all, colorectal cancers.

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