Role of the serrated pathway in colorectal cancer pathogenesis

Gastroenterology. 2010 Jun;138(6):2088-100. doi: 10.1053/j.gastro.2009.12.066.

Abstract

The "serrated neoplastic pathway" describes the progression of serrated polyps, including sessile serrated adenomas and traditional serrated adenomas, to colorectal cancer. The recognition of this pathway during the last 15 years has led to a paradigm shift in our understanding of the molecular basis of colorectal cancer and significant changes in clinical practice. These findings are particularly relevant to prevention of interval cancers through colonoscopy surveillance programs-an important issue for colonoscopists. In the past, all serrated polyps were classified simply as hyperplastic polyps and were considered to have no malignant potential. Reappraisal of this view was largely driven by increasing recognition of the malignant potential of hyperplastic polyposis.

Publication types

  • Portrait
  • Review

MeSH terms

  • Adenoma / genetics
  • Adenoma / pathology*
  • Adenoma / therapy
  • Animals
  • Biopsy
  • Cell Transformation, Neoplastic / genetics
  • Cell Transformation, Neoplastic / pathology*
  • Colonic Polyps / genetics
  • Colonic Polyps / pathology*
  • Colonic Polyps / therapy
  • Colonoscopy
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / prevention & control
  • Gene Expression Regulation, Neoplastic
  • Genetic Predisposition to Disease
  • Humans
  • Microsatellite Instability
  • Mutation
  • Precancerous Conditions / genetics
  • Precancerous Conditions / pathology*
  • Precancerous Conditions / therapy
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors