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- Title
Molecular and Histologic Considerations in the Assessment of Serrated Polyps.
- Authors
Hui-Min Yang; Mitchell, James M.; Sepulveda, Jorge L.; Sepulveda, Antonia R.
- Abstract
Context.—Colorectal cancer is a heterogeneous disease resulting from different molecular pathways of carcinogenesis. Recent data evaluating the histologic features and molecular basis of the serrated polyp-carcinoma pathway have significantly contributed to more comprehensive classifications of and treatment recommendations for these tumors. Objective.—To integrate the most recent molecular findings in the context of histologic classifications of serrated lesions and their implications in diagnostic pathology and colorectal cancer surveillance. Data Sources.—Published literature focused on serrated polyps and their association with colorectal cancer. Conclusions.—Three types of serrated polyps are currently recognized: hyperplastic polyps, sessile serrated adenomas/polyps, and traditional serrated adenomas. The BRAF V600E mutation is one of the most frequent molecular abnormalities identified in hyperplastic polyps and sessile serrated adenomas. In contrast, in traditional serrated adenomas, either BRAF V600E or KRAS mutations can be frequently identified. CpG methylation has emerged as a critical molecular mechanism in the sessile serrated pathway. CpG methylation of MLH1 often leads to reduced or lost expression in dysplastic foci and carcinomas arising in sessile serrated adenomas/polyps.
- Subjects
COLON tumors; GENETIC mutation; DISEASE progression; INTESTINAL polyps; RECTUM tumors; EARLY detection of cancer; ADENOMATOUS polyps; GENETICS; DIAGNOSIS; DISEASE risk factors
- Publication
Archives of Pathology & Laboratory Medicine, 2015, Vol 139, Issue 6, p730
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/arpa.2014-0424-RA