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Sessile serrated adenoma/polyps: Where are we at in 2016?

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ABSTRACT

It is currently known that colorectal cancers (CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway (50%-70%); the mutator “Lynch syndrome” route (3%-5%); and the serrated pathway (30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA/P) and traditional serrated adenomas (TSA), the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare. SSA/P appear to be the responsible precursor lesion for the development of cancers through the serrated pathway. Both HPs and SSA/Ps appear morphologically similar. SSA/P are difficult to detect. The margins are normally inconspicuous. En bloc resection of these polyps can hence be troublesome. A careful examination of borders, submucosal injection of a dye solution (for larger lesions) and resection of a rim of normal tissue around the lesion may ensure total eradication of these lesions.

No MeSH data available.


Related in: MedlinePlus

Inconspicuous margins of a sessile serrated adenomas/polyps with and without narrow-band imaging.
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Figure 1: Inconspicuous margins of a sessile serrated adenomas/polyps with and without narrow-band imaging.

Mentions: Although there is certainly enthusiasm for IEE techniques, histopathology remains the gold standard for evaluating colorectal lesions. Nonetheless, improving technology that could be used by the endoscopist in real time would definitely be beneficial for serrated lesions as it has been for adenomas[26]. This technology will need to provide immediate feedback and accurately predict the final histopathology (Figure 1).


Sessile serrated adenoma/polyps: Where are we at in 2016?
Inconspicuous margins of a sessile serrated adenomas/polyps with and without narrow-band imaging.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016375&req=5

Figure 1: Inconspicuous margins of a sessile serrated adenomas/polyps with and without narrow-band imaging.
Mentions: Although there is certainly enthusiasm for IEE techniques, histopathology remains the gold standard for evaluating colorectal lesions. Nonetheless, improving technology that could be used by the endoscopist in real time would definitely be beneficial for serrated lesions as it has been for adenomas[26]. This technology will need to provide immediate feedback and accurately predict the final histopathology (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

It is currently known that colorectal cancers (CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway (50%-70%); the mutator “Lynch syndrome” route (3%-5%); and the serrated pathway (30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA/P) and traditional serrated adenomas (TSA), the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare. SSA/P appear to be the responsible precursor lesion for the development of cancers through the serrated pathway. Both HPs and SSA/Ps appear morphologically similar. SSA/P are difficult to detect. The margins are normally inconspicuous. En bloc resection of these polyps can hence be troublesome. A careful examination of borders, submucosal injection of a dye solution (for larger lesions) and resection of a rim of normal tissue around the lesion may ensure total eradication of these lesions.

No MeSH data available.


Related in: MedlinePlus