Serrated polyps of the large intestine: current understanding of diagnosis, pathogenesis, and clinical management

Rosty, Christophe, Hewett, David G., Brown, Ian S., Leggett, Barbara A. and Whitehall, Vicki L. J. (2013) Serrated polyps of the large intestine: current understanding of diagnosis, pathogenesis, and clinical management. Journal of Gastroenterology, 48 3: 287-302. doi:10.1007/s00535-012-0720-y


Author Rosty, Christophe
Hewett, David G.
Brown, Ian S.
Leggett, Barbara A.
Whitehall, Vicki L. J.
Title Serrated polyps of the large intestine: current understanding of diagnosis, pathogenesis, and clinical management
Journal name Journal of Gastroenterology   Check publisher's open access policy
ISSN 0944-1174
1435-5922
Publication date 2013-03
Year available 2012
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s00535-012-0720-y
Volume 48
Issue 3
Start page 287
End page 302
Total pages 16
Place of publication Tokyo, Japan
Publisher Springer
Collection year 2014
Language eng
Abstract Approximately 30 % of colorectal carcinomas develop via the serrated neoplasia pathway characterized by widespread DNA methylation and frequent BRAF mutation. Serrated polyps represent a heterogeneous group of polyps which are the precursor lesions to serrated pathway colorectal carcinomas. The histological classification of serrated polyps has evolved over the last two decades to distinguish three separate entities: hyperplastic polyp, sessile serrated adenoma (SSA), and traditional serrated adenoma (TSA). The malignant potential of SSAs and TSAs has been clearly demonstrated. SSAs are more challenging to detect by colonoscopy and are likely to account for some interval carcinomas of the proximal colon. Serrated polyposis syndrome is now widely recognized as conferring a high risk of colorectal carcinoma although its cause remains elusive. The current understanding of the actual malignant potential of each serrated polyp subtype is still limited due to the lack of large-scale prospective studies. Patient management guidelines have been recently updated although high-level evidence to support them is still required.
Keyword Serrated polyps
Colorectal neoplasia
Colonoscopy
Histology
Molecular pathology
Patient management
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Medicine Publications
 
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