Geramizadeh Bita, Robertson Scott
Department of Pathology, Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA.
J Gastrointest Cancer. 2017 Dec;48(4):291-298. doi: 10.1007/s12029-017-9977-y.
In the past decade, there have been significant changes in the classification and nomenclature of colorectal polyps. Previously, only two groups of lesions were widely recognized, the adenoma and the hyperplastic polyp. Adenomas were considered the only precursor of colorectal cancer, and hyperplastic polyps were considered innocent with no malignant potential. However, recent discoveries about molecular pathways of colorectal cancers have significantly changed our understanding of these neoplasms. Serrated polyps-previously uniformly called hyperplastic polyps-are now known to comprise a heterogeneous family of neoplasms united by their characteristic saw tooth morphology but differing in many important ways, including their malignant potential and molecular profile. This group of neoplasms includes both hyperplastic polyps and the more recently recognized serrated adenomas. Serrated adenomas can be subdivided into the traditional serrated adenoma and the sessile serrated adenoma/polyp. Both of these lesions show characteristic molecular changes, which differ from traditional colorectal adenomatous polyps.
In this review, we will discuss the morphologic features of serrated colorectal lesions, the molecular alterations that characterize them, and their role in colorectal cancer development.
The English literature regarding the new nomenclature will be reviewed and the key diagnostic points will be recorded.
This large group of polyps has recently been better classified which needs specific attention by pathologists, gastroenterologists and even surgeons.
在过去十年中，结直肠息肉的分类和命名发生了重大变化。以前，只有两组病变被广泛认可，即腺瘤和增生性息肉。腺瘤被认为是结直肠癌的唯一前体，而增生性息肉被认为是无害的，没有恶性潜能。然而，最近关于结直肠癌分子途径的发现显著改变了我们对这些肿瘤的理解。锯齿状息肉——以前统称为增生性息肉——现在已知是一个异质性肿瘤家族，它们以其特征性的锯齿状形态统一，但在许多重要方面存在差异，包括它们的恶性潜能和分子特征。这组肿瘤包括增生性息肉和最近才被认识的锯齿状腺瘤。锯齿状腺瘤可细分为传统锯齿状腺瘤和无蒂锯齿状腺瘤/息肉。这两种病变都表现出特征性的分子变化，这与传统的结直肠腺瘤性息肉不同。
在本综述中，我们将讨论结直肠锯齿状病变的形态学特征、其特征性的分子改变以及它们在结直肠癌发生中的作用。
将回顾关于新命名法的英文文献并记录关键诊断要点。
最近这一大组息肉得到了更好的分类，这需要病理学家、胃肠病学家甚至外科医生给予特别关注。
