Identification of tumor initiating cells and early marker genes in histologically normal colonic mucosa that lead to neoplastic transformation

Our results identify TICs as the origin of neoplastic stem‑like states in the conventional tubular adenoma pathway and define early transcriptional, metabolic, and microenvironmental reprogramming events that distinguish TICs from nSTMs. In contrast to serrated pathways described in other atlases, our data support a stem‑like expansion model for tubular adenomas and nominate biomarkers with translational potential for early CRC detection and intervention.