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Published on: July 28, 2010
Pathologic features and biologic importance of colorectal serrated polyps
Efsevia Vakiani1, Rhonda K Yantiss
1Department of Pathology, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10065, USA.
Advances in Anatomic Pathology
|June 25, 2009
Summary
Serrated polyps, including hyperplastic and sessile serrated types, are increasingly recognized as precursors to colorectal cancer. Emerging evidence suggests a "serrated neoplastic pathway" involving BRAF mutations and DNA methylation, potentially leading to microsatellite unstable carcinomas.
Area of Science:
- Gastroenterology
- Oncology
- Molecular Pathology
Background:
- Serrated polyps are a heterogeneous group of colorectal mucosal lesions.
- They include nondysplastic (hyperplastic, sessile serrated) and dysplastic (serrated adenomas, mixed) types.
- Recognition of their potential role in colorectal cancer has grown significantly.
Purpose of the Study:
- To review the clinicopathologic and molecular features of serrated polyps.
- To discuss the current data regarding the biologic significance of serrated polyps.
- To explore the proposed
Main Methods:
- Literature review of clinicopathologic and molecular studies.
- Analysis of emerging evidence on the serrated neoplastic pathway.
- Discussion of genetic mutations (BRAF) and epigenetic alterations (DNA methylation).
Main Results:
- A subset of serrated polyps may progress through a neoplastic pathway.
- BRAF mutations and abnormal DNA methylation are implicated in this pathway.
- These molecular changes can lead to microsatellite instability and colorectal cancer.
Conclusions:
- Serrated polyps, particularly sessile serrated polyps, are increasingly considered precursors to specific types of colorectal cancer.
- The serrated neoplastic pathway involves key molecular alterations.
- Further prospective data are needed to confirm treatment and surveillance recommendations.
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