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Correlations of morphology and molecular alterations in Traditional serrated adenoma

World Journal of Gastrointestinal Pathophysiology 2020年第4期11卷 78-83页

作者： Hongxing Gui Michael A Husson Rifat Mannan Department of Pathology and Laboratory Medicine Pennsylvania Hospital of the University of Pennsylvania Health SystemPhiladelphiaPA 19107United States

Traditional serrated adenoma was first reported by Longacre and FenoglioPresier in 1990.Their initial study described main features of this lesion,but the consensus diagnostic criteria were not widely adopted until recently.Traditional serrated adenoma presents with grossly protuberant configuration and pineconelike appearance upon endoscopy.Histologically,it is characterized by ectopic crypt formation,slit-like serration,eosinophilic cytoplasm and pencillate nuclei.Although much is now known about the morphology and molecular changes,the mechanisms underlying the morphological alterations are still not fully understood.Furthermore,the origin of Traditional serrated adenoma is not completely known.We review recent studies of the Traditional serrated adenoma and provide an overview on current understanding of this rare entity.

关键词： Traditional serrated adenoma serrated polyps KRAS BRAF Colon

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Detection Rate, Distribution, Clinical and Pathological Features of Colorectal serrated Polyps

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Chinese Medical Journal 2016年第20期129卷 2427-2433页

作者： Hai-Long Cao Xue Chen Shao-Chun Du Wen-Jing Song Wei-Qiang Wang Meng-Que Xu Si-Nan Wang Mei-Yu Piao Xiao-Cang Cao Bang-Mao Wang Department of Gastroenterology and Hepatology Tianjin Institute of Digestive DiseaseTianjin Medical University General HospitalTianjin 300052China Department of Pathology Tianjin Medical University General HospitalTianjin 300052China

Background：Colorectal serrated polyp is considered as histologically heterogeneous lesions with malignant potential in western countries.However,few Asian studies have investigated the comprehensive clinical features of serrated polyps in symptomatic populations.The aim of the study was to evaluate the features of colorectal serrated polyps in a Chinese symptomatic population.Methods：Data from all consecutive symptomatic patients were documented from a large colonoscopy database and were analyzed.Chi-square test or Fisher＇s exact test and logistic regression analysis were used for the data processing.Results：A total of 9191 （31.7%） patients were detected with at least one colorectal polyp.The prevalence of serrated polyps was 0.53% （153/28,981）.The proportions of hyperplastic polyp （HP）,sessile serrated adenoma/polyp （SSA/P）,and Traditional serrated adenoma （TSA） of all serrated polyps were 41.2%,7.2%,and 51.6%,respectively,which showed a lower proportion of HP and SSA/P and a higher proportion of TSA.serrated polyps appeared more in males and elder patients while there was no significant difference in the subtype distribution in gender and age.The proportions of large and proximal serrated polyps were 13.7% （21/153） and 46.4% （71/153）,respectively.In total,98.9% （89/90） serrated adenomas were found with dysplasia.Moreover,14 patients with serrated polyps were found with synchronous advanced colorectal neoplasia,and large serrated polyps （LSPs）（odds ratio：3.446,95% confidence interval：1.010-11.750,P 〈 0.05）,especially large HPs,might have an association with synchronous advanced neoplasia （AN）.Conclusions：The overall detection rate ofcolorectal serrated polyps in Chinese symptomatic patient population was low,and distribution pattern of three subtypes is different from previous reports.Moreover,LSPs,especially large HPs,might be associated with an increased risk of synchronous AN.

关键词： Colorectal Cancer Colorectal serrated Polyps Hyperplastic Polyp Traditional serrated adenoma Sessile serrated adenoma/Polyp

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serrated polyps of the colon and rectum:Remove or not?

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World Journal of Gastroenterology 2020年第19期26卷 2276-2285页

作者： Wataru Sano Daizen Hirata Akira Teramoto Mineo Iwatate Santa Hattori Mikio Fujita Yasushi Sano Gastrointestinal Center Sano HospitalHyogo 655-0031Japan

In recent years,the serrated neoplasia pathway where serrated polyps arise as a colorectal cancer has gained considerable attention as a new carcinogenic pathway.Colorectal serrated polyps are histopathologically classified into hyperplastic polyps(HPs),sessile serrated lesions,and Traditional serrated adenomas;in the serrated neoplasia pathway,the latter two are considered to be premalignant.In western countries,all colorectal polyps,including serrated polyps,apart from diminutive rectosigmoid HPs are removed.However,in Asian countries,the treatment strategy for colorectal serrated polyps has remained unestablished.Therefore,in this review,we described the clinicopathological features of colorectal serrated polyps and proposed to remove HPs and sessile serrated lesions≥6 mm in size,and Traditional serrated adenomas of any size.

关键词： Hyperplastic polyp Sessile serrated adenoma/polyp Sessile serrated lesion Traditional serrated adenoma Cytological dysplasia Cryptal dysplasia

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