Serrated lesions of the colorectum: review and recommendations from an expert panel.
Serrated lesions of the colorectum: review and recommendations from an expert panel.
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DOI：
10.1038/ajg.2012.161
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发表时间：
2012-09
影响因子：
9.8
通讯作者：
Church, James
中科院分区：
文献类型：
--
作者：
Rex, Douglas K.;Ahnen, Dennis J.;Baron, John A.;Batts, Kenneth P.;Burke, Carol A.;Burt, Randall W.;Goldblum, John R.;Guillem, Jose G.;Kahi, Charles J.;Kalady, Matthew F.;O'Brien, Michael J.;Odze, Robert D.;Ogino, Shuji;Parry, Susan;Snover, Dale C.;Torlakovic, Emina Emilia;Wise, Paul E.;Young, Joanne;Church, James
结直肠锯齿状病变可能是三分之一结直肠癌的先兆。锯齿状病变中产生的癌症通常发生在近端结肠，在结肠镜检查后发现的癌症中所占比例不成比例。我们试图根据有关锯齿状病变的定义、分类和意义的现有证据和专家意见，为锯齿状结直肠病变的临床治疗提供指导。召开了为期两天的共识会议，从组织学、分子生物学、流行病学、临床方面和锯齿状息肉病的角度回顾了锯齿状病变的主题。锯齿状病变应根据世界卫生组织的标准进行病理学分类：增生性息肉、无蒂锯齿状腺瘤/息肉（SSA/P）伴或不伴细胞学不典型增生或传统锯齿状腺瘤（TSA）。 SSA/P 和 TSA 是癌前病变，但 SSA/P 是结直肠癌的主要锯齿状前兆。锯齿状病变具有独特的内镜外观，多项证据表明，平均而言，它们比传统的腺瘤性息肉更难以检测。有效的结肠镜检查需要内镜医师接受过锯齿状病变内镜外观方面的培训。我们建议完全切除乙状结肠近端的所有锯齿状病变和直肠乙状结肠中大小 > 5 毫米的所有锯齿状病变。建议对锯齿状病变进行息肉切除术后监测，并对锯齿状息肉病患者及其亲属进行监测。
Serrated lesions of the colorectum are the precursors of perhaps one-third of colorectal cancers. Cancers arising in serrated lesions are usually in the proximal colon, and account for a disproportionate fraction of cancer identified after colonoscopy. We sought to provide guidance for the clinical management of serrated colorectal lesions based on current evidence and expert opinion regarding definitions, classification and significance of serrated lesions. A consensus conference was held over 2 days reviewing the topic of serrated lesions from the perspectives of histology, molecular biology, epidemiology, clinical aspects, and serrated polyposis. Serrated lesions should be classified pathologically according to World Health Organization criteria as hyperplastic polyps, sessile serrated adenoma/polyp (SSA/P) with or without cytological dysplasia, or traditional serrated adenoma (TSA). SSA/P and TSA are premaligant lesions, but SSA/P is the principle serrated precursor of colorectal cancers. Serrated lesions have a distinct endoscopic appearance, and several lines of evidence suggest that on average they are more difficult to detect than conventional adenomatous polyps. Effective colonoscopy requires an endoscopist trained in the endoscopic appearance of serrated lesions. We recommend that all serrated lesions proximal to the sigmoid colon and all serrated lesions in the rectosigmoid > 5 mm in size, be completely removed. Recommendations are made for post-polypectomy surveillance of serrated lesions and for surveillance of serrated polyposis patients and their relatives.
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影响因子：
7.3
作者：
Carvajal-Carmona, L. G.;Howarth, K. M.;Tomlinson, I. P. M.
通讯作者：
Tomlinson, I. P. M.
影响因子：
29.4
作者：
Chow, Elizabeth;Lipton, Lara;Macrae, Finlay
通讯作者：
Macrae, Finlay
影响因子：
24.5
作者：
Boparai, K. S.;Reitsma, J. B.;Dekker, E.
通讯作者：
Dekker, E.
影响因子：
3.9
作者：
COOPER, HS;PATCHEFSKY, AS;MARKS, G
通讯作者：
MARKS, G
影响因子：
39.2
作者：
Brenner, Hermann;Chang-Claude, Jenny;Hoffmeister, Michael
通讯作者：
Hoffmeister, Michael