INTESTINE Vol.16 No.6(1-1)

Theme How should we interpret sessile serrated adenoma/polyp ?
Title Is SSA/P neoplastic lesion ?
Publish Date 2012/11
Author Tamotsu Sugai Division of Molecular Diagnostic Pathology, Department of Pathology School of Medicine, Iwate Medical University
Author Wataru Habano Department of Pharmacodynamics and Molecular Genetics, School of Pharmacy, Iwate Medical University
Author Hiro-o Yamano Department of Gastroenterology, Akita Red Cross Hospital
Author Eiichirou Yamamoto 1st Department of Internal Medicine, Sapporo Medical University / Department of Molecular Biology, School of Medicine, Sapporo Medical University
Author Hiromu Suzuki Department of Molecular Biology, School of Medicine, Sapporo Medical University
[ Summary ] Previous data suggested that sessile serrated adenomas/polyps (SSA/P) are early precursor lesions in the serrated pathway of carcinogenesis. It is well known that SSA/Ps develop into cancers through an SSA/P-dysplasia-carcinoma sequence. It is unclear whether SSA/Ps are neoplastic or non-neoplastic lesions. SSA/Ps are characterized by BRAF mutations, CIMP (CpG islands methylated phenotype) and MSI (microsatellite instability). In relation to these molecular alterations, BRAF mutation is a commonly observed alteration in hyperplastic polyps, SSA/P and MSI-positive cancer (serrated pathway lesions). Furthermore, SSA/P has distinct histological features, such as dilatation of crypt bases. Those findings suggest that SSA/P is neoplastic in nature.
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