IJspeert Joep Evert Godfried, Medema Jan Paul, Dekker Evelien
Department of Gastroenterology and Hepatology, Academic Medical Center, Meibergdreef 9, Room C2-231, Amsterdam 1105 AZ The Netherlands.
Laboratory for Experimental Oncology and Radiobiology, Center for Experimental Molecular Medicine, Academic Medical Center (AMC), Meibergdreef 9, Room G2-131, Amsterdam 1105 AZ, The Netherlands.
Gastrointest Endosc Clin N Am. 2015 Apr;25(2):169-82. doi: 10.1016/j.giec.2014.11.004. Epub 2015 Jan 10.
Colorectal cancer (CRC) is a heterogeneous disease and each CRC possesses a unique molecular tumor profile. The main pathways of oncogenesis are the chromosomal instability, microsatellite instability and serrated neoplasia pathway. Sessile serrated adenomas/polyps (SSA/Ps) may be the precursor lesions of CRC arising via the serrated neoplasia pathway. This has led to a paradigm shift because all SSA/Ps should be detected and resected during colonoscopy. The ability to accurately detect and resect only those polyps with a malignant potential could result in safer and cost-effective practice. Optimization of the endoscopic classification systems is however needed to implement targeted prevention methods.
结直肠癌（CRC）是一种异质性疾病，每例结直肠癌都具有独特的分子肿瘤特征。肿瘤发生的主要途径是染色体不稳定、微卫星不稳定和锯齿状肿瘤形成途径。无蒂锯齿状腺瘤/息肉（SSA/P）可能是通过锯齿状肿瘤形成途径发生的结直肠癌的前驱病变。这导致了一种范式转变，因为所有SSA/P都应在结肠镜检查期间被检测到并切除。仅准确检测和切除那些具有恶性潜能的息肉的能力可能会带来更安全且具成本效益的做法。然而，需要优化内镜分类系统以实施针对性的预防方法。
