锯齿状途径的结直肠癌筛查。
Colorectal Cancer Screening for the Serrated Pathway.
机构信息
Department of Veterans Affairs Medical Center, White River Junction, VT, USA; The Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA; Division of Gastroenterology and Hepatology, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
出版信息
Gastrointest Endosc Clin N Am. 2020 Jul;30(3):457-478. doi: 10.1016/j.giec.2020.02.007. Epub 2020 Apr 8.
Serrated polyps are classified into hyperplastic polyps, sessile serrated adenomas/polyps, and traditional serrated adenomas. Although all serrated polyps share characteristic colonic crypts serrations, distinguishing hyperplastic polyps from sessile serrated adenomas/polyps is challenging. Traditional serrated adenomas are cytologically dysplastic lesions; sessile serrated adenomas/polyps develop cytologic dysplasia as they progress to colorectal cancer. A flat and pale appearance of serrated polyps may make detection difficult. Endoscopic mucosal resection has higher rates of complete resection. Close surveillance is recommended for sessile serrated adenomas/polyps, sessile serrated adenomas/polyp with dysplasia, hyperplastic polyps ≥10 mm, and traditional serrated adenomas.
锯齿状息肉分为增生性息肉、无蒂锯齿状腺瘤/息肉和传统锯齿状腺瘤。虽然所有锯齿状息肉都具有特征性的结肠隐窝锯齿状，但增生性息肉与无蒂锯齿状腺瘤/息肉的鉴别具有挑战性。传统锯齿状腺瘤是细胞学异型性病变；无蒂锯齿状腺瘤/息肉随着向结直肠癌的发展而出现细胞学异型性。锯齿状息肉的扁平苍白外观可能使检测变得困难。内镜黏膜切除术的完全切除率较高。建议对无蒂锯齿状腺瘤/息肉、伴异型增生的无蒂锯齿状腺瘤/息肉、直径≥10mm 的增生性息肉和传统锯齿状腺瘤进行密切监测。
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