结直肠无蒂锯齿状病变的特征和临床问题

Characteristics and clinical problems of colorectal serrated lesions

无蒂锯齿状息肉/腺瘤(SSL)曾经被认为是良性病变,而现有研究表明,通过锯齿状瘤变途径,约15%~30%的SSL最终发展为结直肠癌。锯齿状息肉分为增生性息肉、无蒂锯齿状病变、伴发育不良的无蒂锯齿性病变、传统锯齿状腺瘤和未分类锯齿状腺瘤,每一种都具有不同的形态学和分子特征。尽管对SSL的理解有所提高,但由于频繁的病理错误分类、结肠内镜检测不足和不完全切除率高,SSL仍然是内镜和病理医生面临的诸多临床挑战。本文总结了目前对锯齿状息肉的新认识和诊断问题。

Serrated polyps(SP)were once considered benign lesions.However,it is now recognized that about 15%to 30%of SPs eventually develop into colorectal cancer through the serrated neoplasia pathway(SNP).Serrated polyps are divided into hyperplastic polyps,sessile serrated lesions,sessile serrated lesions with dysplasia,traditional serrated adenomas and unclassified serrated adenomas,each with different morphological and molecular characteristics.Although the understanding of SP has been im⁃proved,due to frequent pathological error classification,insufficient detection of colonoscopy and high rate of incomplete resection,SP is still a lot of clinical challenges faced by endoscopy and pathologists.This article summarizes the new understanding and diagnosis of serrated polyps.