Sessile serrated adenoma/polyps: Where are we at in 2016?
It is currently known that colorectal cancers (CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway (50%-70%); the mutator "Lynch syndrome" route (3%-5%); and the serrated pathway (30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA/P) and traditional serrated adenomas (TSA), the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare. SSA/P appear to be the responsible precursor lesion for the development of cancers through the serrated pathway. Both HPs and SSA/Ps appear morphologically similar. SSA/P are difficult to detect. The margins are normally inconspicuous. En bloc resection of these polyps can hence be troublesome. A careful examination of borders, submucosal injection of a dye solution (for larger lesions) and resection of a rim of normal tissue around the lesion may ensure total eradication of these lesions.
Rajvinder Singh, Gastroenterology Department, Lyell McEwin and Modbury Hospital, NALHN School of Medicine, University of Adelaide, SA 5112, Australia.
Rajvinder
R
Singh
Rajvinder Singh, Gastroenterology Department, Lyell McEwin and Modbury Hospital, NALHN School of Medicine, University of Adelaide, SA 5112, Australia.
Leonardo
L
Zorrón Cheng Tao Pu
Rajvinder Singh, Gastroenterology Department, Lyell McEwin and Modbury Hospital, NALHN School of Medicine, University of Adelaide, SA 5112, Australia.
Doreen
D
Koay
Rajvinder Singh, Gastroenterology Department, Lyell McEwin and Modbury Hospital, NALHN School of Medicine, University of Adelaide, SA 5112, Australia.
Alastair
A
Burt
D000236:Adenoma / Q000175:diagnosis / Q000473:pathology*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D003111:Colonic Polyps / Q000175:diagnosis / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D018450:Disease Progression; D004724:Endoscopy / Q000379:methods; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis / Q000473:pathology; D017410:Practice Guidelines as Topic; D011230:Precancerous Conditions; D012955:Societies, Medical
Colonoscopy; Colorectal cancer; Colorectal polyps; Image enhancing endoscopy; Narrow band imaging, Endocytoscopy; Polypectomy; Serrated lesion; Sessile serrated adenoma/polyp
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