Pragmatic classification of superficial neoplastic colorectal lesions
Pragmatic classification of superficial neoplastic colorectal lesions
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DOI：
10.1016/j.gie.2009.09.015
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发表时间：
2009-12-01
影响因子：
7.7
通讯作者：
Triadafilopoulos, George
中科院分区：
文献类型：
--
作者：
Lambert, Rene;Kudo, Shin ei;Triadafilopoulos, George
最近，非息肉样前体在结直肠癌中的作用日益显现，对传统的息肉-癌序列提出了挑战。结肠镜检查在癌症预防中的作用取决于它在诊断结直肠肿瘤方面的可靠性，当病变不超过粘膜下层并且有可能治愈时。进展风险的估计是基于从病变的形态外观对组织学的预测，包括(1)肿瘤性和非肿瘤性病变的区分，(2)不同类别的非锯齿状和锯齿状病变的识别，以及(3)对病变的形态和行为有影响的近端或远端结肠的定位。本文提出的浅表肿瘤性病变的实用分类考虑到了这些变化，其基础是内窥镜诊断的两步策略，首先是检测和表征，然后是治疗实施，如内窥镜切除、消融和手术。
Recently, the emerging role of nonpolypoid precursors of colorectal cancer has challenged the conventional polyp-cancer sequence. The impact of colonoscopy in cancer prevention depends on its reliability in the diagnosis of colorectal neoplasia when the lesion does not extend beyond the submucosa and is potentially curable. The estimation of the risk of progression is based on the prediction of histology from the morphological appearance of the lesion and includes (1) distinction between neoplastic and non-neoplastic lesions, (2) identification of different categories of non-serrated and serrated lesions, and (3) determination of the localization in the proximal or distal colon, which has an impact on the morphology and behavior of the lesion. The pragmatic classification Of superficial neoplastic lesions proposed in this text takes into account these changes and is based oil a 2-step strategy of endoscopic diagnosis with initial detection and characterization, followed by treatment implementation, Such as endoscopic resection, ablation, and Surgery