Large proximal serrated polyps: natural history and colorectal cancer risk in a retrospective series.
Large proximal serrated polyps: natural history and colorectal cancer risk in a retrospective series.
复制标题
大近端锯齿状息肉：回顾性系列的自然史和结直肠癌风险。
DOI：
10.1097/mcg.0b013e318293a656
复制
发表时间：
2013
影响因子：
2.9
通讯作者：
Sanduleanu,Silvia
中科院分区：
文献类型：
--
作者：
Bouwens,MariëlleWE;Riedl,RobertG;Bosman,FredT;Driessen,Ann;Sanduleanu,Silvia
致编辑：由于结肠镜检查切除癌前病变可降低结直肠癌的发病率和死亡率，1研究表明结肠镜检查在预防近端癌方面的有效性有限，这引起了严重的关注。2这些结肠镜检查后癌症的许多潜在解释之一是锯齿状肿瘤途径，通过该途径，锯齿状息肉的一个子集，即无蒂锯齿状腺瘤/息肉和传统锯齿状腺瘤，可能发展为结直肠癌。3内窥镜医师对这些病变的检测差异很大，病理学家在组织学分类上存在困难，这可能解释了锯齿状息肉生物学知识的空白。锯齿状息肉目前根据WHO分类法分为增生性息肉、无蒂锯齿状腺瘤/息肉伴或不伴细胞学发育不良和传统锯齿状腺瘤。5国际指南现在认可需要准确诊断和治疗这些病变。我们需要认识到，目前关于他们的生物学行为和癌症风险的数据是稀缺的。6这种信息至关重要，因为它可能构成循证监测建议的基础。在此，我们介绍了我们的经验，自然史和结直肠癌的风险在一个小系列的大近端锯齿状息肉，不完全切除后，随访至少14年。
To the Editor: As colonoscopy with the removal of precancerous lesions reduces the incidence and mortality of colorectal cancer, 1 serious concerns have been raised by studies showing only limited effectiveness of colonoscopy in the prevention of proximal cancer. 2 One of the many potential explanations for these postcolonoscopy cancers is the serrated neoplastic pathway, through which a subset of serrated polyps, namely sessile serrated adenomas/polyps and traditional serrated adenomas, might develop into colorectal cancer. 3 The large variation in the detection of these lesions among endoscopists in conjunction with the difficulties in histologic classification by pathologists4 might explain the gaps in knowledge about the biology of serrated polyps. Serrated polyps are currently classified according to the WHO classification into hyperplastic polyps, sessile serrated adenomas/polyps with or without cytological dysplasia, and traditional serrated adenomas. 5 International guidelines now endorse the need for accurate diagnosis and treatment of these lesions. We need to realize that data currently available about their biological behavior and cancer risk are scarce. 6 Such information is crucial, as it may form the basis for evidence-based surveillance recommendations. Herewith, we present our experience with regard to the natural history and colorectal cancer risk in a small series of large proximal serrated polyps, after incomplete removal and a follow-up of at least 14 years.