Colorectal cancers (CRCs) display recurrent, non-random patterns of chromosome gains and losses, yet the functional contribution of these aneuploidies to colorectal tumorigenesis remains unclear. Mechanistic insights into the oncogenic driver potential of aneuploidy require improved experimental models that recapitulate CRC patient-relevant aneuploidy patterns. Developing such models demands a clear understanding of how aneuploidy evolves during the progression from pre-malignant adenoma to carcinoma and how aneuploidy patterns vary across CRC subtypes. In this review, we highlight and discuss context-dependent alterations in the aneuploidy landscape of CRC, examining associations with tumor subtype, tumor stage, whole-genome doubling, TP53 status, and metastatic organotropism. Through a synthesis of the current literature and meta-analysis of publicly available bulk sequencing datasets of colorectal carcinomas and colorectal adenomas, this review provides a comprehensive CRC aneuploidy framework to guide future studies aimed at unraveling the mechanistic and clinical implications of these copy-number alterations.
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