Tischoff I, Tannapfel A
Institut für Pathologie der Ruhr-Universität Bochum, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland.
Internist (Berl). 2013 Jun;54(6):691-8. doi: 10.1007/s00108-012-3213-4.
Preneoplastic lesions of colorectal carcinoma can be divided in non-serrated and serrated lesions. Non-serrated lesions include conventional adenomas (tubular, tubulovillous and villous) and dysplasias associated with inflammatory bowel disease like flat intraepithelial neoplasia, dysplasia-associated lesions or masses (DALM) and adenoma-like masses (ALM). Conventional adenomas are mostly sporadic, but also found in hereditary adenomatous-polyposis syndromes. Hamartous polyposis syndromes are also associated with colorectal cancer. Serrated lesions include hyperplastic polyps, sessile serrated adenomas and traditional serrated adenomas. Based on these precancerous colorectal lesions different molecular subtypes were identified. Histological subtype, size and grade of dysplasia of polyps are essential for risk assessment of colorectal cancer.
结直肠癌的癌前病变可分为非锯齿状病变和锯齿状病变。非锯齿状病变包括传统腺瘤（管状、管状绒毛状和绒毛状）以及与炎症性肠病相关的发育异常，如扁平上皮内瘤变、发育异常相关病变或肿块（DALM）和腺瘤样肿块（ALM）。传统腺瘤大多为散发性，但也见于遗传性腺瘤性息肉病综合征。错构瘤性息肉病综合征也与结直肠癌有关。锯齿状病变包括增生性息肉、无蒂锯齿状腺瘤和传统锯齿状腺瘤。基于这些结直肠癌前病变，已确定了不同的分子亚型。息肉的组织学亚型、大小和发育异常程度对于结直肠癌的风险评估至关重要。
