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Clinical and endoscopic characteristics of colorectal traditional serrated adenomas with dysplasia/adenocarcinoma in a Korean population
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作者 Ki-Hyun Kim Eun Myung +10 位作者 Hyung Hoon Oh Chan-Muk Im Young-Eun Seo Je-Seong Kim Chae-June Lim Ga-Ram You Sung-Bum Cho Wan-Sik Lee Myung-Giun Noh Kyung-Hwa Lee Young-Eun Joo 《World Journal of Gastrointestinal Oncology》 2025年第2期119-131,共13页
BACKGROUND Traditional serrated adenoma(TSA)is a rare and precancerous lesion of colorectal cancer.The clinical and endoscopic differentiations between TSAs without dysplasia or adenocarcinoma(TSAOs)and TSAs with dysp... BACKGROUND Traditional serrated adenoma(TSA)is a rare and precancerous lesion of colorectal cancer.The clinical and endoscopic differentiations between TSAs without dysplasia or adenocarcinoma(TSAOs)and TSAs with dysplasia or adenocarcinoma(TSADs)remain unclear.AIM To evaluate the characteristics of colorectal TSAs and compare the characteristics of TSAOs with those of TSADs.METHODS This retrospective study included 193 patients who underwent endoscopic resection and received a pathologic diagnosis of TSA.We reviewed the medical,endoscopic,and histopathologic records of patients who underwent endoscopic resection of TSAs between January 2010 and December 2023.RESULTS TSAs were more frequently located in the rectosigmoid colon.Most TSAs had 0-Ip,0-Isp,or 0-Is morphologies.The TSAD lesions were larger than TSAO lesions.TSAD lesions more commonly had a red color and an irregular border than TSAO lesions.TSAOs were usually treated using conventional endoscopic mucosal resection,whereas TSADs were treated using conventional endoscopic mucosal resection,endoscopic submucosal dissection,and surgery.Post-polypectomy bleeding was more common with TSADs than with TSAOs.Univariate analysis showed that gastrointestinal bleeding,red color,0-IIa,irregular border,and lobular mucosal surface were significantly associated with TSADs.Multivariate analysis showed that gastrointestinal bleeding,an irregular border,and a lobular mucosal surface were significantly associated with TSADs.CONCLUSION TSAs with gastrointestinal bleeding,an irregular border,and a lobular mucosal surface are associated with an increased risk of dysplasia or adenocarcinoma. 展开更多
关键词 Traditional serrated adenoma DYSPLASIA CARCINOMA Endoscopic features Gastrointestinal bleeding
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A general model for trailing edge serrations simulation on wind turbine airfoils 被引量:3
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作者 Huijing Cao Mingming Zhang +1 位作者 Yinan Zhang Teng Zhou 《Theoretical & Applied Mechanics Letters》 CSCD 2021年第4期236-244,共9页
Trailing edge serrations(TESs)are capable of noticeably suppressing the turbulent trailing edge noise induced by rotating wind turbine blades and become an integral part of a blade.However,the challenges involved in t... Trailing edge serrations(TESs)are capable of noticeably suppressing the turbulent trailing edge noise induced by rotating wind turbine blades and become an integral part of a blade.However,the challenges involved in the dimensional design of serration height 2 h,wavelengthλand flap angleϕare yet to be dealt with in a satisfactory manner.To address the problem,a general model for simulating the effects of serrations on the hydrodynamic and aeroacoustic performance is proposed due to its ease of use and relatively low requirements for user input.The solid serrations are replicated by momentum sources calculated by its aerodynamic forces.Then,a case relevant to wind turbine airfoil is examined,a hybrid improved delay detached eddy simulation(IDDES)method coupled with FW-H integration is deployed to obtain the flow features and far-field sound pressure level.It is found that the modeling method could reproduce the flow field and noise as serrated airfoil. 展开更多
关键词 Wind turbine airfoil Trailing edge serrations Trailing edge noise Modeling method
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Design and test of pneumatic artificial muscle driven variable trailing-edge camber wing 被引量:1
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作者 尹维龙 田东奎 陈以金 《Journal of Harbin Institute of Technology(New Series)》 EI CAS 2012年第4期99-103,共5页
A variable camber wing driven by pneumatic artificial muscles is developed in this paper. Firstly, the experimental setup to measure the static output force of pneumatic artificial muscle is designed and the relations... A variable camber wing driven by pneumatic artificial muscles is developed in this paper. Firstly, the experimental setup to measure the static output force of pneumatic artificial muscle is designed and the relationship between the static output force and the air pressure is investigated. Experimental results show that the static output force of pneumatic artificial muscle decreases nonlinearly with the increase of contraction ratio. Secondly, the model of variable camber wing driven by pneumatic artificial muscles is manufactured to validate the variable camber concept. Finally, wind tunnel tests are conducted in the low speed wind tunnel. It is found that the wing camber increases with the increase of air pressure. When the air pressure of PAMs is 0.4 MPa and 0.5 MPa, the tip displacement of the trailing-edge is 3 mm and 5 mm, respectively. The lift of aerofoil with flexible trailing-edge increases by 87% at AOA of 5°. 展开更多
关键词 variable trailing-edge camber pneumatic artificial muscle flexible skin wind tunnel test
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Prevalence, risk factors, and BRAF mutation of colorectal sessile serrated lesions among Vietnamese patients 被引量:1
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作者 Nhu Thi Hanh Vu Huy Minh Le +4 位作者 Diem Thi-Ngoc Vo Hoang Anh Vu Nhan Quang Le Dung Dang Quy Ho Duc Trong Quach 《World Journal of Clinical Oncology》 2024年第2期290-301,共12页
BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma path... BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma pathway,with limited data on the serrated pathway.AIM To evaluate the prevalence,risk factors,and BRAF mutations of SSLs in the Vietnamese population.METHODS This is a cross-sectional study conducted on patients with lower gastrointestinal symptoms who underwent colonoscopy at a tertiary hospital in Vietnam.SSLs were diagnosed on histopathology according to the 2019 World Health Organi-zation classification.BRAF mutation analysis was performed using the Sanger DNA sequencing method.The multivariate logistic regression model was used to determine SSL-associated factors.RESULTS There were 2489 patients,with a mean age of 52.1±13.1 and a female-to-male ratio of 1:1.1.The prevalence of SSLs was 4.2%[95%confidence interval(CI):3.5-5.1].In the multivariate analysis,factors significantly associated with SSLs were age≥40[odds ratio(OR):3.303;95%CI:1.607-6.790],male sex(OR:2.032;95%CI:1.204-3.429),diabetes mellitus(OR:2.721;95%CI:1.551-4.772),and hypertension(OR:1.650,95%CI:1.045-2.605).The rate of BRAF mutations in SSLs was 35.5%.CONCLUSION The prevalence of SSLs was 4.2%.BRAF mutations were present in one-third of SSLs.Significant risk factors for SSLs included age≥40,male sex,diabetes mellitus,and hypertension. 展开更多
关键词 Colorectal cancer Sessile serrated lesion BRAF mutation Risk factors Diabetes mellitus Hypertension
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解脲沙雷菌(Serratia ureilytica)次级代谢产物及其抗菌活性研究
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作者 魏艳梅 张东辉 +2 位作者 莫土香 李鹏 陈光英 《海南师范大学学报(自然科学版)》 CAS 2024年第3期331-337,共7页
本研究对一株海洋来源细菌(Serratia ureilytica)的次级代谢产物进行系统分离。采用多种柱色谱分离方法从该菌中分离得到16个单体化合物,运用NMR技术鉴定所得化合物分别为:环(色氨酸-丝氨酸)(1)、环(甘氨酸-色氨酸)(2)、环(苯丙氨酸-谷... 本研究对一株海洋来源细菌(Serratia ureilytica)的次级代谢产物进行系统分离。采用多种柱色谱分离方法从该菌中分离得到16个单体化合物,运用NMR技术鉴定所得化合物分别为:环(色氨酸-丝氨酸)(1)、环(甘氨酸-色氨酸)(2)、环(苯丙氨酸-谷氨酰胺)(3)、环(亮氨酸-谷氨酰胺)(4)、环(L-酪氨酸-4-羟基-D-脯氨酸)(5)、环(L-苯丙氨酸-4-羟基-D-脯氨酸)(6)、环(L-苯丙氨酸-4-羟基-L-脯氨酸)(7)、环(L-4-羟基-脯氨酸-L-亮氨酸)(8)、环(脯氨酸-酪氨酸)(9)、环(D-脯氨酸-L-酪氨酸)(10)、环(S-脯氨酸-S-亮氨酸)(11)、环(L-脯氨酸-L-缬氨酸)(12)、环(酪氨酸-甘氨酸)(13)、环(R-苯丙氨酸-S-丝氨酸)(14)、环(L-苯丙氨酸-甘氨酸)(15)和环(甘氨酸-亮氨酸)(16)。化合物1~16均为首次从解脲沙雷菌中分离得到。抗菌活性显示,粗提物对青枯菌有显著的拮抗作用,而单体化合物对青枯菌以及5株人体致病菌均无明显活性。 展开更多
关键词 解脲沙雷菌 次级代谢产物 抗菌活性
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Superficial Serrated Adenoma (SuSA): A New Subtype of Serrated Lesions
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作者 Rui Chen Qing Zhang 《Journal of Biosciences and Medicines》 2024年第5期91-98,共8页
Superficial serrated adenoma (SuSA) is a new subtype of serrated lesions proposed in recent years, most of which are located in the sigmoid colon or rectum, with typical mixed adenoma and serrated pathological feature... Superficial serrated adenoma (SuSA) is a new subtype of serrated lesions proposed in recent years, most of which are located in the sigmoid colon or rectum, with typical mixed adenoma and serrated pathological features, and its molecular features are high frequency of KRAS mutation and RSPO fusion or overexpression. At present, it is believed that SuSA has two subtypes: traditional serrated adenoma (TSA)-associated SuSA and isolated SuSA. Solitary SuSA showed faded pedicle-free protuberant lesions under endoscope and lobulated, pp (pit pattern) classification was type II and type IIIH, TSA-associated SuSA showed double-layer eminence, SuSA part showed white flat eminence, pp classification showed type II and IIIH, TSA part showed red tone high eminence, pp was IVH type. SuSA can develop into colorectal cancer through the evolution of TSA, and it can also directly develop into MSS colorectal cancer. In view of the superficial understanding of SuSA and the lack of a complete description of SuSA, this paper review the research progress of SuSA at home and abroad from the origin, endoscope features, histopathological features, molecular biology, differential diagnosis and treatment of SuSA, in order to better promote the understanding and clinical diagnosis of lesions. 展开更多
关键词 Colorectal Cancer serrated Lesion Superficial serrated Adenoma COLONOSCOPY
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How to"pick up"colorectal serrated lesions and polyps in daily histopathology practice:From terminologies to diagnostic pitfalls
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作者 Thai H Tran Vinh H Nguyen Diem TN Vo 《World Journal of Clinical Oncology》 2024年第9期1157-1167,共11页
Over the last decade,our knowledge of colorectal serrated polyps and lesions has significantly improved due to numerous studies on this group of precursor lesions.Serrated lesions were misleading as benign before 2010... Over the last decade,our knowledge of colorectal serrated polyps and lesions has significantly improved due to numerous studies on this group of precursor lesions.Serrated lesions were misleading as benign before 2010,but they are currently reclassified as precancerous lesions that contribute to 30%of colorectal cancer through the serrated neoplasia pathway.The World Health Organization updated the classification for serrated lesions and polyps of the colon and rectum in 2019,which is more concise and applicable in daily practice.The responsible authors prescribe that“colorectal serrated lesions and polyps are characterized by a serrated(sawtooth or stellate)architecture of the epithelium.”From a clinical standpoint,sessile serrated lesion(SSL)and SSL with dysplasia(SSLD)are the two most significant entities.Despite these advancements,the precise diagnosis of SSL and SSLD based mainly on histopathology remains challenging due to various difficulties.This review describes the nomenclature and the terminology of colorectal serrated polyps and lesions and highlights the diagnostic criteria and obstacles encountered in the histopathological diagnosis of SSL and SSLD. 展开更多
关键词 Sessile serrated lesions Sessile serrated lesions with dysplasia serrated polyps Sessile serrated adenoma Benign hyperplastic polyps serrated lesions/polyps
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人工智能在结直肠无蒂锯齿状病变中的应用进展
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作者 赵优冬 卫佳慧 +3 位作者 张颂 李兆申 赵胜兵 柏愚 《海军军医大学学报》 北大核心 2025年第1期24-31,共8页
结直肠无蒂锯齿状病变(SSL)是一种重要的结直肠癌癌前病变,也是间期结直肠癌的重要原因。结直肠SSL虽然具有独特的组织结构和形态学特征,但内镜下检出率低,组织病理学诊断变异度高,是结直肠癌筛查中最易漏诊的病变之一。近年来,人工智... 结直肠无蒂锯齿状病变(SSL)是一种重要的结直肠癌癌前病变,也是间期结直肠癌的重要原因。结直肠SSL虽然具有独特的组织结构和形态学特征,但内镜下检出率低,组织病理学诊断变异度高,是结直肠癌筛查中最易漏诊的病变之一。近年来,人工智能在结直肠疾病诊断中的应用迅速增多,已有研究发现人工智能辅助内镜技术可提高结直肠SSL的检出率和诊断准确性,辅助病理诊断可提高诊断效率和一致性。本文就当前人工智能在结直肠SSL中的应用进展进行综述。 展开更多
关键词 人工智能 结直肠肿瘤 无蒂锯齿状病变 结肠镜检查 病理诊断
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结直肠表浅锯齿状腺瘤11例内镜诊治的回顾性分析
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作者 刘揆亮 岳冰 +5 位作者 王继龙 孟凡冬 徐瑞 陈光勇 李鹏 张澍田 《胃肠病学和肝病学杂志》 2025年第1期6-10,共5页
目的总结结直肠表浅锯齿状腺瘤(superficial serrated adenoma,SuSA)的临床病理特征、内镜表现及治疗效果。方法回顾性分析2021年12月至2023年1月于首都医科大学附属北京友谊医院行结直肠病变内镜下切除,病理诊断为SuSA的病例资料。结... 目的总结结直肠表浅锯齿状腺瘤(superficial serrated adenoma,SuSA)的临床病理特征、内镜表现及治疗效果。方法回顾性分析2021年12月至2023年1月于首都医科大学附属北京友谊医院行结直肠病变内镜下切除,病理诊断为SuSA的病例资料。结果共纳入11例患者,其中女性8例(79.2%),中位年龄63岁(42~76岁),病变中位长径1.5 cm(1.5~2.5 cm),8例(79.2%)位于乙状结肠及直肠;白光下以发白色调(9/11,80.2%)多见,均边界清楚,多有分叶(10/11,90.9%)。11例病变中有5例为传统型锯齿状腺瘤(traditional serrated adenoma,TSA)相关SuSA,其中4例有双层隆起表现(4/11,36.4%),TSA相关SuSA的长径明显大于孤立性SuSA[(2.2±0.4)cm vs(1.58±0.2)cm,P<0.05]。10例患者行内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗,除1例外均为整块切除。有3例(29.7%)病变术后病理评估提示水平切缘阳性,均为TSA相关SuSA。有1例TSA相关SuSA中的TSA成分合并局灶癌变。结论SuSA多位于直肠及乙状结肠,具有一定的内镜下特点。TSA相关SuSA相对较大,多有双层隆起,内镜下切除时应注意识别病变浅表隆起部分的边界。 展开更多
关键词 结直肠表浅锯齿状腺瘤 结直肠传统锯齿状腺瘤 结直肠锯齿状病变
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高熵合金中的锯齿流变行为研究进展
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作者 刘博浩 郝荣 乔珺威 《中国材料进展》 北大核心 2025年第1期61-73,123,124,共15页
高熵合金由于其独特的合金组成和多种元素的均匀分布,展现出了传统合金无法比拟的优异力学性能、热稳定性和耐腐蚀性。因此,这类新型材料近年来成为材料科学领域的研究热点之一。在高熵合金的塑性变形过程中,锯齿流变行为是一种十分重... 高熵合金由于其独特的合金组成和多种元素的均匀分布,展现出了传统合金无法比拟的优异力学性能、热稳定性和耐腐蚀性。因此,这类新型材料近年来成为材料科学领域的研究热点之一。在高熵合金的塑性变形过程中,锯齿流变行为是一种十分重要且典型的现象,它通常表现为应力-应变曲线中的不规则波动。该行为揭示了材料内部复杂的动力学机制,与动态应变时效和位错运动等微观结构演变密切相关。研究表明,在不同的外部条件下,锯齿流变行为会呈现出不同的特征,并对材料的力学性能产生显著影响。近年来,学者们在锯齿流变行为的发生机理、影响因素及其对高熵合金材料性能的作用机理方面进行了广泛的研究,揭示了高熵合金内部位错滑移、局部应变集中等现象的本质。系统综述了高熵合金中锯齿流变行为的最新研究进展,重点讨论了锯齿流变行为的理论基础、实验方法以及特征参数的定量分析,旨在为进一步提高高熵合金的力学性能和工程应用提供理论指导。 展开更多
关键词 高熵合金 锯齿流变 PLC效应 临界应变 平均场理论 数字图像相关法
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Endoscopic diagnosis of sessile serrated adenoma/polyp with and without dysplasia/carcinoma 被引量:25
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作者 Takashi Murakami Naoto Sakamoto Akihito Nagahara 《World Journal of Gastroenterology》 SCIE CAS 2018年第29期3250-3259,共10页
Sessile serrated adenoma/polyps(SSA/Ps) are early precursor lesions in the serrated neoplasia pathway, which results in colorectal carcinomas with BRAF mutations, methylation for DNA repair genes, a Cp G island methyl... Sessile serrated adenoma/polyps(SSA/Ps) are early precursor lesions in the serrated neoplasia pathway, which results in colorectal carcinomas with BRAF mutations, methylation for DNA repair genes, a Cp G island methylator phenotype, and high levels of microsatellite instability. Some of these lesions can rapidly become dysplastic or invasive carcinomas that exhibit high lymphatic invasion and lymph node metastasis potentials. Detecting serrated lesions, including SSA/Ps with and without dysplasia/carcinoma, is critical, but SSA/Ps can be difficult to detect, are inconsistently identified by endoscopists and pathologists, and are often incompletely resected. Therefore, SSA/Ps are considered to be major contributors to "interval cancers". If colonoscopists can identify the specific endoscopic characteristics of SSA/Ps, their detection and the effectiveness of colonoscopy may improve. Here, the endoscopic features of SSA/Ps with and without dysplasia/carcinoma, including the characteristics determined using magnifying endoscopy, are reviewed in the context of previous reports. Endoscopically, these subtle polyps are like hyperplastic polyps, because they are slightly elevated and pale. Unlike hyperplastic polyps, SSA/Ps are usually larger than 5 mm, frequently covered by a thin layer called the ‘‘mucus cap'', and are more commonly located in the proximal colon. Magnifying narrow-band imaging findings, which include dark spots inside the crypts and varicose microvascular vessels, in addition to the type II-open pit patterns detected using magnifying chromoendoscopy, effectively differentiate SSA/Ps from hyperplastic polyps. The lesions' endoscopic characteristics, which include their(semi)pedunculated morphologies, double elevations, central depressions, and reddishness, and the use of magnifying endoscopy, might help to detect dysplasia/carcinoma within SSA/Ps. Greater awareness may promote further research into improving the detection, identification, and complete resection rates of SSA/Ps with and without dysplasia/carcinoma and reduce the interval cancer rates. 展开更多
关键词 Sessile serrated adenoma/polyp INVASIVE CARCINOMA arising from sessile serrated adenoma/polyp serrated NEOPLASIA pathway Endoscopic diagnosis Sessile serrated adenoma/polyp with cytological DYSPLASIA
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Sessile serrated adenoma/polyps: Where are we at in 2016? 被引量:15
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作者 Rajvinder Singh Leonardo Zorrón Cheng Tao Pu +1 位作者 Doreen Koay Alastair Burt 《World Journal of Gastroenterology》 SCIE CAS 2016年第34期7754-7759,共6页
It is currently known that colorectal cancers(CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway(50%-70%); the mutator "Lynch syndrome" route(3%-5%); and the serra... It is currently known that colorectal cancers(CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway(50%-70%); the mutator "Lynch syndrome" route(3%-5%); and the serrated pathway(30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps(HP),sessile serrated adenomas/polyps(SSA/P) and traditional serrated adenomas(TSA),the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare. SSA/P appear to be the responsible precursor lesion for the development of cancers through the serrated pathway. Both HPs and SSA/Ps appear morphologically similar. SSA/P are difficult to detect. The margins are normally inconspicuous. En bloc resection of these polyps can hence be troublesome. A careful examination of borders,submucosal injection of a dye solution(for larger lesions) and resection of a rim of normal tissue around the lesion may ensure total eradication of these lesions. 展开更多
关键词 Colonoscopy Sessile serrated adenoma/ POLYP serrated lesion COLORECTAL POLYPS COLORECTAL cancer POLYPECTOMY Image enhancing endoscopy Narrow band imaging ENDOCYTOSCOPY
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Serrated colorectal cancer: Molecular classification, prognosis, and response to chemotherapy 被引量:18
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作者 Oscar Murcia Miriam Juárez +4 位作者 Eva Hernández-Illán Cecilia Egoavil Mar Giner-Calabuig María Rodríguez-Soler Rodrigo Jover 《World Journal of Gastroenterology》 SCIE CAS 2016年第13期3516-3530,共15页
Molecular advances support the existence of an alternative pathway of colorectal carcinogenesis that is based on the hypermethylation of specific DNA regions that silences tumor suppressor genes. This alternative path... Molecular advances support the existence of an alternative pathway of colorectal carcinogenesis that is based on the hypermethylation of specific DNA regions that silences tumor suppressor genes. This alternative pathway has been called the serrated pathway due to the serrated appearance of tumors in histological analysis. New classifications for colorectal cancer(CRC) were proposed recently based on genetic profiles that show four types of molecular alterations: BRAF gene mutations, KRAS gene mutations, microsatellite instability, and hypermethylation of Cp G islands. This review summarizes what is known about the serrated pathway of CRC, including CRC molecular and clinical features, prognosis, and response to chemotherapy. 展开更多
关键词 COLORECTAL cancer Methylator PHENOTYPE serrated pathway CHEMOTHERAPY CIMP
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Endoscopic and histologic characteristics of serrated lesions 被引量:15
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作者 Driffa Moussata Gilles Boschetti +5 位作者 Marion Chauvenet Karine Stroeymeyt Stéphane Nancey Franoise Berger Thierry Lecomte Bernard Flourié 《World Journal of Gastroenterology》 SCIE CAS 2015年第10期2896-2904,共9页
In recent years , a second pathway for colonic carcinogenesis , distinct from the adenomatous pathway, has been explored. This is referred to as serrated pathway and includes three types of polyp,characterised by a se... In recent years , a second pathway for colonic carcinogenesis , distinct from the adenomatous pathway, has been explored. This is referred to as serrated pathway and includes three types of polyp,characterised by a serrated appearance of the crypts:hyperplastic polyps(HP),sessile serrated adenomas(SSA)or lesions,and traditional serrated adenomas.Each lesion has its own genetic,as well as macroscopic and microscopic morphological features.Because of their flat aspect,their detection is easier with chromoendoscopy(carmin indigo or narrow-band imaging).However,as we show in this review,the distinction between SSA and HP is quite difficult.It is now recommended to resect in one piece as it is possible the serrated polyps with a control in a delay depending on the presence or not of dysplasia.These different types of lesion are described in detail in the present review in general population,in polyposis and in inflammatory bowel diseases patients.This review highlights the need to improve characterization and understanding of this way of colorectal cancerogenesis. 展开更多
关键词 Hyperplastic POLYP TRADITIONAL serrated ADENOMA Se
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Serrated pathway:Alternative route to colorectal cancer 被引量:5
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作者 rpád V Patai Béla Molnár +1 位作者 Zsolt Tulassay Ferenc Sipos 《World Journal of Gastroenterology》 SCIE CAS 2013年第5期607-615,共9页
Serrated polyps have been an area of intense focus for gastroenterologists over the past several years. Contrary to what was thought before,a growing body of literature indicates that these polyps can be precursors of... Serrated polyps have been an area of intense focus for gastroenterologists over the past several years. Contrary to what was thought before,a growing body of literature indicates that these polyps can be precursors of colorectal cancer(CRC).Most of these lesions, particularly those in the proximal colon,have so far been under-recognized and missed during colonoscopy,qualifying these lesions to be the main cause of interval cancers.It is estimated that 10%-20%of CRCs evolve through this alternative,serrated pathway, with a distinct genetic and epigenetic profile.Aberrant DNA methylation plays a central role in the development of this CRC subtype.This characteristic molecular background is reflected in a unique pathological and clinical manifestation different from cancers arising via the traditional pathway.In this review we would like to highlight morphological,molecular and clinical features of this emerging pathway that are essential for gastroenterologists and may influence their everyday practice. 展开更多
关键词 serrated pathway DNA METHYLATION Hyperplastic POLYPS serrated ADENOMAS COLORECTAL cancer ENDOSCOPIC surveillance
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Serrated polyps of the colon and rectum: Endoscopic features including image enhanced endoscopy 被引量:8
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作者 Shoichi Saito Hisao Tajiri Masahiro Ikegami 《World Journal of Gastrointestinal Endoscopy》 CAS 2015年第9期860-871,共12页
In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy(IEE). Histopathologically, lesions with serrated structures are typically classi... In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy(IEE). Histopathologically, lesions with serrated structures are typically classified into the following three types based: hyperplastic polyps(HPs), traditional serrated adenomas(TSAs), and sessile serrated adenoma/polyps(SSA/Ps). Both HP and SSA/P often present as dark-green colors on auto fluorescence imaging(AFI) colonoscopy that are similar to the normal surrounding mucosa. In contrast, TSAs often have elevated shapes and present as magenta colors that are similar to the tubular adenomas. The superficial type of TSA also includes many lesions that present as magenta colors. When SSA/Ps are associated with cytological dysplasia, many lesions present with magenta colors, whereas lesions that are not associated with cytological dysplasia present with dark-green colors. When observed via narrow band imaging(NBI), many SSA/P include lesions with strong mucous adhesions. Because these lesions are observed with reddish mucous adhesions, we refer to them as "red cap sign" and place such signs among the typical findings of SSA/P. Because the dilatation of the pit in SSA/P is observed as a round/oval black dot on magnified observations, we refer to this finding as Ⅱ-dilatation pit(Ⅱ-D pit) and also positioned it as a characteristic finding of SSA/P. In contrast, dilatations of the capillary vessels surrounding the glands, such as those that occur in tubular adenoma, are not considered to be useful for differentiating HPs from SSA/Ps. However, in cases in which SSA/P is associated with cytological dysplasia, the dilatation of capillary vessels is observed in the same area. When submucosal layer invasion occurs in the same area, the blood flow presents with irregularities that are similar to those of common colorectal cancer at an early stage and disappears as the invasion proceeds deeply. The surface pattern of invasive cancer that is observed at the tumor surface is also likely to disappear. Based on the above results, we considered that the differentiations between HP and TSA, between TSA and SSA/P, and between HP and SSA/P might become easier due to the concomitant use of white light observation and IEE. We also concluded that AFI and NBI can be useful modalities for SSA/P lesions associated with cytological dysplasia. 展开更多
关键词 IMAGE ENHANCED ENDOSCOPY Hyperplasticpolyp Early COLON cancer Traditional serrated ADENOMA Sessile serrated adenoma/polyp
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Sessile serrated adenomas:Demographic,endoscopic and pathological characteristics 被引量:7
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作者 Suryakanth R Gurudu Russell I Heigh +5 位作者 Giovanni De Petris Evelyn G Heigh Jonathan A Leighton Shabana F Pasha Isaac B Malagon Ananya Das 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第27期3402-3405,共4页
AIM:To study the demographic and endoscopic characteristics of patients with sessile serrated adenoma(SSA) in a single center.METHODS:Patients with SSA were identified by review of the pathology database of Mayo Clini... AIM:To study the demographic and endoscopic characteristics of patients with sessile serrated adenoma(SSA) in a single center.METHODS:Patients with SSA were identified by review of the pathology database of Mayo Clinic Arizona from 2005 to 2007.A retrospective chart review was performed to extract data on demographics,polyp characteristics,presence of synchronous adenomatous polyps or cancer,polypectomy methods,and related complications.RESULTS:One hundred and seventy-one(2.9%) of all patients undergoing colonoscopy had a total of 226 SSAs.The mean(SE) size of the SSAs was 8.1(0.4) mm;42% of SSAs were ≤ 5 mm,and 69% were ≤ 9 mm.Fifty-one per cent of SSAs were located in the cecum or ascending colon.Approximately half of the patients had synchronous polyps of other histological types,including hyperplastic and adenomatous polyps.Synchronous adenocarcinoma was present in seven(4%) cases.Ninety-seven percent of polyps were removed by colonoscopy.CONCLUSION:Among patients with colon polyps,2.9% were found to have SSAs.Most of the SSAs were located in the right side and were safely managed by colonoscopy. 展开更多
关键词 Sessile serrated polyp Sessile serrated adenoma COLONOSCOPY
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Serrated pathway in colorectal carcinogenesis 被引量:9
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作者 Letícia Yamane Cristovam Scapulatempo-Neto +1 位作者 Rui Manuel Reis Denise Peixoto Guimares 《World Journal of Gastroenterology》 SCIE CAS 2014年第10期2634-2640,共7页
Serrated adenocarcinoma is a recently described subset of colorectal cancer(CRC),which account for about10%of all CRCs and follows an alternative pathway in which serrated polyps replace the traditional adenoma as the... Serrated adenocarcinoma is a recently described subset of colorectal cancer(CRC),which account for about10%of all CRCs and follows an alternative pathway in which serrated polyps replace the traditional adenoma as the precursor lesion to CRC.Serrated polyps form a heterogeneous group of colorectal lesions that includes hyperplastic polyps(HPs),sessile serrated adenoma(SSA),traditional serrated adenoma(TSA)and mixed polyps.HPs are the most common serrated polyp followed by SSA and TSA.This distinct histogenesis is believed to have a major influence in prevention strategies,patient prognosis and therapeutic impact.Genetically,serrated polyps exhibited also a distinct pattern,with KRAS and BRAF having an important contribution to its development.Two other molecular changes that have been implicated in the serrated pathway include microsatellite instability and the CpG island methylator phenotype.In the present review we will address the current knowledge of serrated polyps,clinical pathological features and will update the most recent findings of its molecular pathways.The understanding of their biology and malignancy potential is imperative to implement a surveillance approach in order to prevent colorectal cancer development. 展开更多
关键词 serrated pathway Colorectal carcinogenesis MUTATION Microsatellite instability CpG island methylator phenotype
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Serrated polyps of the colon and rectum:Remove or not? 被引量:14
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作者 Wataru Sano Daizen Hirata +4 位作者 Akira Teramoto Mineo Iwatate Santa Hattori Mikio Fujita Yasushi Sano 《World Journal of Gastroenterology》 SCIE CAS 2020年第19期2276-2285,共10页
In recent years,the serrated neoplasia pathway where serrated polyps arise as a colorectal cancer has gained considerable attention as a new carcinogenic pathway.Colorectal serrated polyps are histopathologically clas... In recent years,the serrated neoplasia pathway where serrated polyps arise as a colorectal cancer has gained considerable attention as a new carcinogenic pathway.Colorectal serrated polyps are histopathologically classified into hyperplastic polyps(HPs),sessile serrated lesions,and traditional serrated adenomas;in the serrated neoplasia pathway,the latter two are considered to be premalignant.In western countries,all colorectal polyps,including serrated polyps,apart from diminutive rectosigmoid HPs are removed.However,in Asian countries,the treatment strategy for colorectal serrated polyps has remained unestablished.Therefore,in this review,we described the clinicopathological features of colorectal serrated polyps and proposed to remove HPs and sessile serrated lesions≥6 mm in size,and traditional serrated adenomas of any size. 展开更多
关键词 Hyperplastic polyp Sessile serrated adenoma/polyp Sessile serrated lesion Traditional serrated adenoma Cytological dysplasia Cryptal dysplasia
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Case of pediatric traditional serrated adenoma resected via endoscopic submucosal dissection 被引量:5
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作者 Sonoko Kondo Hirohito Mori +4 位作者 Noriko Nishiyama Takeo Kondo Ryuichi Shimono Hitoshi Okada Takashi Kusaka 《World Journal of Gastroenterology》 SCIE CAS 2017年第24期4462-4466,共5页
Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/p... Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/polyps,and TSAs.TSA is the least common of the three types and accounts for about 5% of serrated polyps.Here we report a pediatric case of TSA that was successfully resected by endoscopic submucosal dissection(ESD).This rare case report describes a pediatric patient with no family history of colonic polyp who was admitted to our hospital with hematochezia.On colonoscopy,we found a polypoid lesion measuring 10 mm in diameter in the lower rectum.We selected ESD as a surgical option for en bloc resection,and histopathological examination revealed TSA.The findings in this case suggest that TSA with precancerous potential can occur in children,and that ESD is useful for treating this lesion. 展开更多
关键词 Pediatric colonic polyp HEMATOCHEZIA Colorectal serrated lesions Traditional serrated adenoma Endoscopic mucosal resection Endoscopic submucosal dissection
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