Sporadic and syndromic hyperplastic polyps and serrated adenomas of the colon: classification, molecular genetics, natural history, and clinical management.
There is now strong evidence for an alternative pathway of colorectal carcinogenesis implicating hyperplastic polyps and serrated adenomas. This article briefly reviews the evidence for this serrated pathway, provides diagnostic criteria for clinically significant hyperplastic polyps and allied serrated polyps, and suggests how this information may be translated into safe, effective guidelines for colonoscopy-based colon cancer prevention. Consideration also is given to the definition and management of hyperplastic polyposis syndrome. The currently proposed management plan for serrated polyps is tentative because of incomplete knowledge of the nature and behavior of these polyps. This article highlights key areas warranting further research.
East
James E
JE
Wolfson Unit for Endoscopy, St. Mark's Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK. jameseast6@yahoo.com
Saunders
Brian P
BP
Jass
Jeremy R
JR
D000236:Adenoma / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D003110:Colonic Neoplasms / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D003111:Colonic Polyps / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D003113:Colonoscopy / Q000379:methods*; D004273:DNA, Neoplasm / Q000032:analysis; D003937:Diagnosis, Differential; D020022:Genetic Predisposition to Disease; D006801:Humans; D008967:Molecular Biology / Q000379:methods*; D009857:Oncogenes / Q000235:genetics*; D011379:Prognosis; D012720:Severity of Illness Index
D004273:DNA, Neoplasm