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The adenoma-carcinoma sequence. Activation of the Wnt signalling pathway, by an inactivating adenomatous polyposis coli (APC) mutation or an activating β-catenin mutation, is regarded as the first step in the adenoma-carcinoma sequence. Then, additional mutations in oncogenes (for example, K-Ras) and tumour suppressor genes (for example, p53 and SMAD4) drive further progression of the adenoma-carcinoma sequence. COX-2, cyclooxygenase 2.
