Serrated adenoma and colorectal cancer

Hyperplastic polyps and serrated adenomas of the colorectum show mixed gastrointestinal differentiation, expressing both gastric (M1 or MUC5AC) and intestinal (MUC2) mucins. They also share the phenotype of mild DNA microsatellite instability (MSI-L). Recent findings of clonal genetic changes within hyperplastic polyps fit with a pathway of serrated neoplasia, perhaps culminating in the subset of colorectal cancer characterized by the mild mutator phenotype.