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Clinico-pathological aspects of colorectal serrated adenomas

World Journal of Gastroenterology 2006年第17期12卷 2770-2772页

作者： Ashish Chandra Adnan A Sheikh Anton Cerar Ian C Talbot Department of Pathology St Thomas' Hospital Lambeth Palace RoadLondonSE1 7EHUnited Kingdom Department of Surgery Royal Liverpool University Hospital Prescot RoadLiverpoolL7 8XPUnited Kingdom Institute of Pathology Medical Faculty Korytkova 21105 LjubljanaSlovenia Academic Department of Pathology St Mark's and Northwick Park Hospitals NHS Trust HarrowMiddlesexHA1 3UJUnited Kingdom

AIM： To study the association of colorectal serrated adenomas （SAs） with invasive carcinoma, local recurrence, synchronicity and metachronicity of lesions. METHODS： A total of 4536 polyps from 1096 patients over an eight-year period （1987-1995） were retrospectively examined. adenomas showing at least 50% of serrated architecture were called SAs by three reviewing pathologists. RESULTS： Ninety-one （2%） of all polyps were called SAs, which were found in 46 patients. Invasive carcinomas were seen in 3 out of 46 （6.4%） patients, of whom one was a case of familial adenomatous polyposis （FAP）. A male preponderance was noted and features of a mild degree of dysplasia were seen in majority （n=75, 83%） of serrated adenomas. Follow-up ranged 1-12 years with a mean time of 5.75 years. Recurrences of SAs were seen in 3 （6.4%） cases, synchronous SAs in 16 （34.8%） cases and metachronous SAs in 9 （19.6%） cases. CONCLUSION： Invasive carcinoma arising in serrated adenoma is rare, accounting for 2 （4.3%） cases studied in this series.

关键词： serrated adenoma Carcinoma Polyps Colorectum

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serrated neoplasia of the colorectum

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World Journal of Gastroenterology 2007年第28期13卷 3792-3798页

作者： Nathan T Harvey Andrew Ruszkiewicz Division of Tissue Pathology Institute of Medical and Veterinary ScienceFrome RdAdelaideAustralia

serrated polyps of the colorectum form a group of related lesions which include aberrant crypt foci (ACF), conventional hyperplastic polyps, mixed (admixed) polyps, serrated adenomas and sessile serrated adenomas. In recent years the molecular differences between these morphologically similar lesions have been highlighted, and their differing biological potential has been realised. In particular, the sessile serrated adenoma has become recognised as the precursor lesion to a group of sporadic colorectal carcinomas characterised by morphological and molecular features distinct from conventional adenomas. These recent findings have challenged the long held paradigm that all colorectal carcinomas arise via the traditional adenoma-carcinoma sequence. In addition, they present a major challenge for the early detection and management of colorectal cancer, which is no longer regarded as a homogeneous entity.

关键词： serrated adenoma serrated neoplasia serrated adenocarcinoma Hyperplastic polyps Microsatellite instability

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Hyperplastic polyposis associated with two asynchronous colon cancers

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World Journal of Gastroenterology 2007年第23期13卷 3255-3258页

作者： Masaya Kurobe Kuniko Abe Naoe Kinoshita Masanobu Anami Hirotaka Tokai Yoshinori Ryu Chun Yang Wen Takashi Kanematsu Tomayoshi Hayashi Department of Pathology Nagasaki University Hospital Nagasaki 852-8501 Japan Department of Transplantation and Digestive Surgery Nagasaki University Graduate School of Biomedical Science Nagasaki 852-8501 Japan Department of Digestive Disease Center Bei Hua University 3999 Huashan Road Jilin 132013 Jilin Province China

We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precancerous lesion; and adenocarcinoma arises from hyperplastic polyposis through the hyperplastic polyp-adenoma-carcinoma sequence. Most polyps in patients with hyperplastic polyposis present as bland- looking hyperplastic polyps, which are regarded as non- neoplastic lesions; however, the risk of malignancy should not be underestimated. In patients with multiple hyperplastic polyps, hyperplastic polyposis should be identified and followed up carefully in order to detect malignant transformation in the early stage.

关键词： Hyperplastic polyposis Hyperplastic polyp Adenocarcinoma serrated adenoma Multiple cancer

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