Epithelial-mesenchymal and mesenchymal-epithelial transitions during cancer progression.

Invasion by colorectal carcinomas is characterized by an epithelial-mesenchymal transition (EMT)-like de-differentiation of the tumor cells. However a re-differentiation towards an epithelial phenotype, resembling a mesenchymal-epithelial transition (MET) is detectable in metastases. This indicates that malignant progression is based on dynamic processes, which can not be explained solely by irreversible genetic alterations, but must be additionally regulated by the tumor environment. The main oncoprotein in colorectal cancer is the Wnt-pathway effector beta-catenin, which is overexpressed due to mutations in the APC tumor suppressor in most cases. EMT of the tumor cells is associated with a nuclear accumulation of the transcriptional activator beta-catenin, which is reversed in metastases. Nuclear beta-catenin is involved in two fundamental processes in embryonic development: EMT and stem cell formation. Accumulating data demonstrate that aberrant nuclear expression of beta-catenin can confere these two abilites also to tumor cells. The unusual combination of EMT with stem cell competence might result in a migrating tumor stem cell, which drives tumor invasion and metastasis.