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The histologic features, molecular features, detection and management of serrated polyps: a review. | LitMetric

AI Article Synopsis

  • - The serrated pathway to colorectal cancers (CRCs) involves five types of lesions: hyperplastic polyps, sessile serrated lesions, sessile serrated lesions with dysplasia, traditional serrated adenomas, and unclassified serrated adenomas, each playing different roles in cancer development.
  • - This pathway diverges from the conventional adenoma-carcinoma pathway, primarily involving mutations (BRAF/KRAS) and a specific methylation pattern (CIMP) that are crucial for understanding CRC progression.
  • - Effective management requires distinguishing these lesions via histological and colonoscopic evaluation, with recommendations for timely removal of premalignant lesions and ongoing surveillance to improve colorectal cancer screening outcomes.

Article Abstract

The serrated pathway to colorectal cancers (CRCs) is a significant pathway encompassing five distinct types of lesions, namely hyperplastic polyps (HPs), sessile serrated lesions (SSLs), sessile serrated lesions with dysplasia (SSL-Ds), traditional serrated adenomas (TSAs), and serrated adenoma unclassified. In contrast to the conventional adenoma-carcinoma pathway, the serrated pathway primarily involves two mechanisms: BRAF/KRAS mutations and CpG island methylator phenotype (CIMP). HPs are the most prevalent non-malignant lesions, while SSLs play a crucial role as precursors to CRCs, On the other hand, traditional serrated adenomas (TSAs) are the least frequently encountered subtype, also serving as precursors to CRCs. It is crucial to differentiate these lesions based on their unique morphological characteristics observed in histology and colonoscopy, as the identification and management of these serrated lesions significantly impact colorectal cancer screening programs. The management of these lesions necessitates the crucial steps of removing premalignant lesions and implementing regular surveillance. This article provides a comprehensive summary of the epidemiology, histologic features, molecular features, and detection methods for various serrated polyps, along with recommendations for their management and surveillance.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10955069PMC
http://dx.doi.org/10.3389/fonc.2024.1356250DOI Listing

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