Sessile Serrated Adenomas: An Evidence-Based Guide to Management

被引:59
作者
Crockett, Seth D. [1 ]
Snover, Dale C. [2 ]
Ahnen, Dennis J. [3 ,4 ]
Baron, John A. [1 ]
机构
[1] Univ N Carolina, Div Gastroenterol & Hepatol, Sch Med, Chapel Hill, NC 27599 USA
[2] Fairview Southdale Hosp, Dept Pathol, Edina, MN USA
[3] Dept Vet Affairs Eastern Colorado Hlth Care Syst, Div Gastroenterol, Denver, CO USA
[4] Univ Colorado, Sch Med, Denver, CO USA
关键词
Sessile Serrated Adenoma; Sessile Serrated Polyp; Serrated Neoplasia; Colorectal Cancer Screening; Colonoscopy; Endoscopic Detection; Polypectomy; ABERRANT CRYPT FOCI; SOCIETY TASK-FORCE; COLORECTAL-CANCER; PROXIMAL COLON; MICROSATELLITE INSTABILITY; POLYPOSIS SYNDROME; CT COLONOGRAPHY; LARGE-INTESTINE; BRAF MUTATION; HYPERPLASTIC POLYPOSIS;
D O I
10.1016/j.cgh.2013.10.035
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The concept of serrated colorectal neoplasia and a serrated pathway to colorectal cancer (CRC) is relatively new and continuing to evolve, but it has become highly relevant to gastroenterologists, pathologist, and oncologists alike. Sessile serrated adenomas (SSA) are now thought to be the major precursor lesion of serrated pathway cancers, which represent up to one-third of all sporadic CRC cases. However, despite their increasingly recognized importance, relatively little is known about the epidemiology and natural history of SSAs, and the molecular and epigenetic aspects are incompletely understood. Endoscopists must be aware of the unique features of SSAs so that the practice of colonoscopic screening for CRC can include optimized detection, removal, and appropriate surveillance of SSAs and other serrated precursor lesions. In this review, we discuss the history, epidemiology, and pathologic aspects of SSAs, as well as a recommended management approach and a discussion of uncertainties and opportunities for future research.
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页码:11 / +
页数:17
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