Hyperplastic polyps of the colorectum - Innocent or guilty?
Hyperplastic polyps of the colorectum - Innocent or guilty?
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DOI：
10.1007/bf02234287
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发表时间：
2001-02-01
影响因子：
3.9
通讯作者：
Jass, JR
中科院分区：
文献类型：
--
作者：
Jass, JR
增生性息肉传统上被认为是没有恶性潜能的非肿瘤性息肉。这些病变内的遗传改变表明潜在的肿瘤原因。有证据表明增生性息肉是异质性的。大多数是无害的，但子集可能具有恶性潜力。肿瘤进展的危险因素包括多发性、大的和近端息肉。导致癌症基因沉默的异常甲基化可能是一个重要的潜在机制，特别是在具有DNA微卫星不稳定性的肿瘤进展途径中。介于增生性息肉和癌之间的病变包括钦佩性息肉和锯齿状腺瘤。目前，病理学家对诊断锯齿状腺瘤有不同的阈值，包括与大增生性息肉的区别。过去忽视这一途径的原因可能包括肿瘤进展迅速，以及近端增生性息肉可能是扁平的，数量不多。结直肠肿瘤的锯齿状通路的管理可能需要新的方法来筛查，早期发现和预防。
Hyperplastic polyps have traditionally been regarded as nonneoplastic polyps lacking malignant potential. The demonstration of genetic alterations within these lesions indicates an underlying neoplastic cause. There is evidence that hyperplastic polyps are heterogeneous. Most are innocuous, but subsets may have malignant potential. Risk factors for neoplastic progression include multiple, large, and proximally located polyps. Aberrant methylation resulting in the silencing of cancer genes may be an important underlying mechanism, particularly in pathways progressing to tumors with DNA microsatellite instability. Lesions intermediate between hyperplastic polyp and cancer include admired polyps and serrated adenomas. Currently, pathologists have different thresholds for diagnosing serrated adenomas, including the distinction from large hyperplastic polyps. Reasons for over looking this pathway in the past may include rapid tumor progression and the fact that proximally located hyperplastic polyps may be flat and not especially numerous. Management of the serrated pathway of colorectal neoplasia may require novel approaches to screening, early detection, and prevention.