Dhillon Angad Singh, Ibraheim Hajir, Green Susi, Suzuki Noriko, Thomas-Gibson Siwan, Wilson Ana
Wolfson Unit for Endoscopy, St Mark's Hospital, London, UK.
Guy's and Saint Thomas' NHS Foundation Trust, London, UK.
Frontline Gastroenterol. 2019 Jun 5;11(3):243-248. doi: 10.1136/flgastro-2018-101153. eCollection 2020.
Colorectal cancer (CRC) is the second leading cause of death from cancer in the UK. Sporadic CRC evolves by the cumulative effect of genetic and epigenetic alterations. Typically, over the course of several years, this leads to the transformation of normal colonic epithelium to benign adenomatous polyp, low-grade to high-grade dysplasia and finally cancer-the adenoma-carcinoma sequence. Over the last decade, the serrated neoplasia pathway which progresses by methylation of tumour suppressing genes has been increasingly recognised as an important alternative pathway accounting for up to 30% of CRC cases. Endoscopists should be aware of the unique features of serrated lesions so that their early detection, appropriate resection and surveillance interval can be optimised.
在英国，结直肠癌（CRC）是癌症致死的第二大主要原因。散发性结直肠癌通过遗传和表观遗传改变的累积效应而演变。通常，在数年的过程中，这会导致正常结肠上皮转变为良性腺瘤性息肉、低级别到高级别发育异常，最终发展为癌症——即腺瘤-癌序列。在过去十年中，通过肿瘤抑制基因甲基化进展的锯齿状肿瘤形成途径越来越被认为是一条重要的替代途径，占结直肠癌病例的30%。内镜医师应了解锯齿状病变的独特特征，以便优化其早期检测、适当切除和监测间隔。
