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serrated lesions

Sunday 22 September 2013

serrated precursor lesion; serrated precursor lesions; Serrated lesions of the colorectum

Serrated lesions of the colorectum are the precursors of perhaps one-third of colorectal cancers (CRCs).

Serrated lesions should be classified pathologically according to the World Health Organization criteria as:
- hyperplastic polyp,
- sessile serrated adenoma / polyp (SSA/P) with or without cytological dysplasia,
- traditional serrated adenoma (TSA).

SSA/P and TSA are premalignant lesions, but SSA/P is the principal serrated precursor of CRCs.

Serrated lesions have a distinct endoscopic appearance, and several lines of evidence suggest that on average they are more difficult to detect than conventional adenomatous polyps.

Effective colonoscopy requires an endoscopist trained in the endoscopic appearance of serrated lesions.

All serrated lesions proximal to the sigmoid colon and all serrated lesions in the rectosigmoid > 5 mm in size, should be completely removed.

Open references

- Serrated lesions of the colorectum: review and recommendations from an expert panel. Rex DK, Ahnen DJ, Baron JA, Batts KP, Burke CA, Burt RW, Goldblum JR, Guillem JG, Kahi CJ, Kalady MF, O’Brien MJ, Odze RD, Ogino S, Parry S, Snover DC, Torlakovic EE, Wise PE, Young J, Church J. Am J Gastroenterol. 2012 Sep;107(9):1315-29; quiz 1314, 1330. doi : 10.1038/ajg.2012.161 PMID: 22710576 [Free]

- Significance of serrated polyps of the colon. Groff RJ, Nash R, Ahnen DJ. Curr Gastroenterol Rep. 2008 Oct;10(5):490-8. PMID: 18799125 [Free]

- Serrated neoplasia of the colorectum. Harvey NT, Ruszkiewicz A. World J Gastroenterol. 2007 Jul 28;13(28):3792-8. PMID: 17657832 [Free]


- Poor-prognosis colon cancer is defined by a molecularly distinct subtype and develops from serrated precursor lesions. De Sousa E Melo F, Wang X, Jansen M, Fessler E, Trinh A, de Rooij LP, de Jong JH, de Boer OJ, van Leersum R, Bijlsma MF, Rodermond H, van der Heijden M, van Noesel CJ, Tuynman JB, Dekker E, Markowetz F, Medema JP, Vermeulen L. Nat Med. 2013 May;19(5):614-8. doi : 10.1038/nm.3174 PMID: 23584090