Journal ArticleDOI
Sessile serrated adenoma (SSA) vs. traditional serrated adenoma (TSA)
Emina Torlakovic,Jose D. Gomez,David K. Driman,Jeremy Parfitt,Chang Wang,Tama Benerjee,Dale C. Snover +6 more
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TLDR
The presence of the ECF defines TSA in a more rigorous fashion than previous diagnostic criteria and also explains the biologic basis of exuberant protuberant growth associated with TSA and the lack of such growth in SSA.Abstract:
The morphologic distinction between various serrated polyps of the colorectum may be challenging. The distinction between sessile serrated adenoma (SSA) and traditional serrated adenoma (TSA) may be difficult using currently available criteria mostly based on cytologic characteristics. We have evaluated 66 serrated polyps including 29 SSA, 18 TSA, and 19 hyperplastic polyps for overall shape of the polyps, architectural features of individual crypts, the presence of eosinophilic cytoplasm, size and distribution of the proliferation and maturation zones, as well as Ki-67 and CK20 expression. The extent of the expression of CK20 and Ki-67 could not distinguish between the 3 types of serrated polyps, but the distribution of their expression was very helpful and differences were statistically significant. The distribution of Ki-67+ cells was the single most helpful distinguishing feature of the serrated polyp type (P<0.0001, chi test). Hyperplastic polyps had regular, symmetric, and increased Ki-67 expression. SSA had irregular, asymmetric, and highly variable expression of Ki-67. TSA had low Ki-67 expression, which was limited to "ectopic crypts" and admixed tubular adenomalike areas. In serrated polyps, ectopic crypt formation (ECF) defined by the presence of ectopic crypts with their bases not seated adjacent to the muscularis mucosae was nearly exclusive to TSA and was found in all cases, while the presence of cytologic atypia and eosinophilia of the cytoplasm were characteristic, but not limited to TSA. No evidence of ECF, but nevertheless abnormal distribution of proliferation zone was characteristic of SSA, whereas HP had neither. The presence of the ECF defines TSA in a more rigorous fashion than previous diagnostic criteria and also explains the biologic basis of exuberant protuberant growth associated with TSA and the lack of such growth in SSA. Recognition of this phenomenon may also help in exploring the genetic and molecular basis for differences between SSA and TSA, because these architectural abnormalities may well be a reflection of abnormalities in genetically programmed mucosal development.read more
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Journal ArticleDOI
Serrated Lesions of the Colorectum: Review and Recommendations From an Expert Panel
Douglas K. Rex,Dennis J. Ahnen,John A. Baron,Kenneth P. Batts,Carol A. Burke,Randall W. Burt,John R. Goldblum,Jose G. Guillem,Charles J. Kahi,Matthew F. Kalady,Michael J. O'Brien,Robert D. Odze,Shuji Ogino,Susan Parry,Susan Parry,Dale C. Snover,Emina Torlakovic,Paul E. Wise,Joanne P. Young,James M. Church +19 more
TL;DR: It is recommended that all serrated lesions proximal to the sigmoid colon and allserrated lesions in the rectosigmoid >5 mm in size, be completely removed.
Journal ArticleDOI
Role of the serrated pathway in colorectal cancer pathogenesis.
TL;DR: The recognition of this pathway during the last 15 years has led to a paradigm shift in understanding of the molecular basis of colorectal cancer and significant changes in clinical practice, and these findings are particularly relevant to prevention of interval cancers through colonoscopy surveillance programs.
Journal ArticleDOI
Accuracy of CT Colonography for Detection of Large Adenomas and Cancers
C. Daniel Johnson,Mei Hsiu Chen,Alicia Y. Toledano,Jay P. Heiken,Abraham H. Dachman,Mark D. Kuo,Christine O. Menias,Betina Siewert,Jugesh I. Cheema,Richard G. Obregon,Jeff L. Fidler,Peter Zimmerman,Karen M. Horton,Kevin J. Coakley,Revathy B. Iyer,Amy K. Hara,Robert A. Halvorsen,Giovanna Casola,Judy Yee,Benjamin A. Herman,Lawrence J. Burgart,Paul J. Limburg +21 more
TL;DR: In this study of asymptomatic adults, CT colonographic screening identified 90% of subjects with adenomas or cancers measuring 10 mm or more in diameter, augmenting published data on the role of CT colonography in screening patients with an average risk of colorectal cancer.
Journal ArticleDOI
Update on the serrated pathway to colorectal carcinoma.
TL;DR: The various pathways to colorectal carcinoma are reviewed with emphasis on the serrated pathway and the implications of this pathway for coloreCTal carcinomas screening programs are evaluated.
Journal ArticleDOI
Epigenetics and colorectal cancer
TL;DR: Progress in the understanding of aberrant methylation in CRC has led to epigenetic alterations being developed as clinical biomarkers for diagnostic, prognostic and therapeutic applications, and it is suggested that these methylated alterations will be commonly used in the near future to direct the prevention and treatment of CRC.
References
More filters
Journal ArticleDOI
The beta-catenin/TCF-4 complex imposes a crypt progenitor phenotype on colorectal cancer cells.
Marc van de Wetering,Elena Sancho,Cornelis Verweij,Wim de Lau,Irma Oving,Adam Hurlstone,Karin van der Horn,Eduard Batlle,Damien Coudreuse,Anna-Pavlina G. Haramis,Menno Tjon-Pon-Fong,Petra Moerer,Maaike van den Born,Gwen Soete,Steven T. Pals,Martin Eilers,René H. Medema,Hans Clevers +17 more
TL;DR: The β-catenin/TCF-4 complex constitutes the master switch that controls proliferation versus differentiation in healthy and malignant intestinal epithelial cells.
Journal ArticleDOI
Stem cells: attributes, cycles, spirals, pitfalls and uncertainties. Lessons for and from the crypt.
TL;DR: A novel concept to describe structured cell populations in tissues involving stem cells, transit cells and mature cells is attempted, based on the primary assumption that the proliferation and differentiation/maturation processes are in principle independent entities in the sense that each may proceed without necessarily affecting the other.
Journal ArticleDOI
Classification of colorectal cancer based on correlation of clinical, morphological and molecular features
TL;DR: The molecular pathways are determined at an early evolutionary stage and are fully established within precancerous lesions and should accelerate understanding of causation and will impact on clinical management in the areas of both prevention and treatment.
Journal ArticleDOI
Integrins and anoikis
Steven M. Frisch,Erkki Ruoslahti +1 more
TL;DR: Results indicate that caspase-mediated cleavage of the first component of this latter pathway, MEKK-1, may trigger activation of this pathway in anoikis, and certain integrins may regulate bcl-2 expression levels, possibly adjusting the threshold for ano Kikis.
Journal ArticleDOI
Tumorigenesis: RAF/RAS oncogenes and mismatch-repair status.
Harith Rajagopalan,Alberto Bardelli,Christoph Lengauer,Kenneth W. Kinzler,Bert Vogelstein,Victor E. Velculescu +5 more
TL;DR: The results not only provide genetic support for the idea that mutations in BRAF and KRAS exert equivalent effects in tumorigenesis, but also emphasize the role of repair processes in establishing the mutation spectra that underpin human cancer.
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