Wang Rui-Gang, Wei Lai, Jiang Bo
Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Department of Digestive Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
World J Clin Oncol. 2023 Apr 24;14(4):171-178. doi: 10.5306/wjco.v14.i4.171.
Along with the discovery and refinement of serrated pathways, the World Health Organization amended the classification of digestive system tumors in 2019, recommending the renaming of sessile serrated adenomas/polyps to sessile serrated lesions (SSLs). Given the particularity of the endoscopic appearance of SSLs, it could easily be overlooked and missed in colonoscopy screening, which is crucial for the occurrence of interval colorectal cancer. Existing literature has found that adequate bowel preparation, reasonable withdrawal time, and awareness of colorectal SSLs have improved the quality and accuracy of detection. More particularly, with the continuous advancement and development of endoscopy technology, equipment, and accessories, a potent auxiliary tool is provided for accurate observation and immediate diagnosis of SSLs. High-definition white light endoscopy, chromoendoscopy, and magnifying endoscopy have distinct roles in the detection of colorectal SSLs and are valuable in identifying the size, shape, character, risk degree, and potential malignant tendency. This article delves into the relevant factors influencing the detection rate of colorectal SSLs, reviews its characteristics under various endoscopic techniques, and expects to attract the attention of colonoscopists.
随着锯齿状通路的发现和完善,世界卫生组织于2019年修订了消化系统肿瘤的分类,建议将无蒂锯齿状腺瘤/息肉重新命名为无蒂锯齿状病变(SSLs)。鉴于SSLs内镜表现的特殊性,在结肠镜筛查中很容易被忽视和漏诊,而结肠镜筛查对于间隔期结直肠癌的发生至关重要。现有文献发现,充分的肠道准备、合理的退镜时间以及对结直肠SSLs的认识提高了检测的质量和准确性。更具体地说,随着内镜技术、设备和附件的不断进步和发展,为SSLs的准确观察和即时诊断提供了有力的辅助工具。高清白光内镜、色素内镜和放大内镜在结直肠SSLs的检测中具有不同的作用,对于识别其大小、形状、特征、风险程度和潜在恶性倾向具有重要价值。本文深入探讨了影响结直肠SSLs检出率的相关因素,回顾了其在各种内镜技术下的特征,并期望引起结肠镜检查医师的关注。