Serrated lesions of the colon and rectum: Emergent epidemiological data and molecular pathways
| Title: | Serrated lesions of the colon and rectum: Emergent epidemiological data and molecular pathways |
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| Authors: | Sacco Michele, De Palma Fatima Domenica Elisa, Guadagno Elia, Giglio Mariano Cesare, Peltrini Roberto, Marra Ester, Manfreda Andrea, Amendola Alfonso, Cassese Gianluca, Dinuzzi Vincenza Paola, Pegoraro Francesca, Tropeano Francesca Paola, Luglio Gaetano, De Palma Giovanni Domenico |
| Source: | Open Medicine, Vol 15, Iss 1, Pp 1087-1095 (2020) |
| Publisher Information: | De Gruyter, 2020. |
| Publication Year: | 2020 |
| Collection: | LCC:Medicine |
| Subject Terms: | colorectal cancer, serrated adenomas, molecular pathways, interval cancer, braf, Medicine |
| More Details: | In 2010, serrated polyps (SP) of the colon have been included in the WHO classification of digestive tumors. Since then a large corpus of evidence focusing on these lesions are available in the literature. This review aims to analyze the present data on the epidemiological and molecular aspects of SP. Hyperplastic polyps (HPs) are the most common subtype of SP (70–90%), with a minimal or null risk of malignant transformation, contrarily to sessile serrated lesions (SSLs) and traditional serrated adenomas (TSAs), which represent 10–20% and 1% of adenomas, respectively. The malignant transformation, when occurs, is supported by a specific genetic pathway, known as the serrated-neoplasia pathway. The time needed for malignant transformation is not known, but it may occur rapidly in some lesions. Current evidence suggests that a detection rate of SP ≥15% should be expected in a population undergoing screening colonoscopy. There are no differences between primary colonoscopies and those carried out after positive occult fecal blood tests, as this screening test fails to identify SP, which rarely bleed. Genetic similarities between SP and interval cancers suggest that these cancers could arise from missed SP. Hence, the detection rate of serrated-lesions should be evaluated as a quality indicator of colonoscopy. There is a lack of high-quality longitudinal studies analyzing the long-term risk of developing colorectal cancer (CRC), as well as the cancer risk factors and molecular tissue biomarkers. Further studies are needed to define an evidence-based surveillance program after the removal of SP, which is currently suggested based on experts’ opinions. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2391-5463 2020-0226 |
| Relation: | http://www.degruyter.com/view/j/med.2020.15.issue-1/med-2020-0226/med-2020-0226.xml?format=INT; https://doaj.org/toc/2391-5463 |
| DOI: | 10.1515/med-2020-0226 |
| Access URL: | https://doaj.org/article/ec2391d38afe4d338c927b9379c9ef2c |
| Accession Number: | edsdoj.2391d38afe4d338c927b9379c9ef2c |
| Database: | Directory of Open Access Journals |
| ISSN: | 23915463 20200226 |
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| DOI: | 10.1515/med-2020-0226 |
| Published in: | Open Medicine |
| Language: | English |