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Archives of Pathology & Laboratory... Oct 2021During the past 3 decades, numerous articles in the literature have offered terminology, diagnostic criteria, and consensus recommendations regarding the entity... (Review)
Review
CONTEXT.—
During the past 3 decades, numerous articles in the literature have offered terminology, diagnostic criteria, and consensus recommendations regarding the entity currently referred to by the World Health Organization as sessile serrated lesion. Given the many names and various, variably reproducible diagnostic criteria ascribed to sessile serrated lesion, confusion persists for many pathologists and gastroenterologists regarding the diagnosis. This distinction is important, as sessile serrated lesion can progress to malignancy, unlike its main differential diagnosis, hyperplastic polyp. Research studies have shed light on the characteristic architecture and morphology, immunohistochemical patterns, and molecular alterations of sessile serrated lesion, and multiple consensus meetings around the globe have developed their criteria and nomenclature, often clashing or mixing terms.
OBJECTIVE.—
To provide a narrative review from the entity's early description to our current understanding.
DATA SOURCES.—
The existing scientific and clinical literature, published texts, medical society recommendations, and specialty consensus guidelines.
CONCLUSIONS.—
The current World Health Organization criteria are a distillation of this scientific process, but terminology is still a point of contention worldwide.
Topics: Adenomatous Polyps; Carcinoma; Colonic Polyps; Diagnosis, Differential; Humans; Intestinal Polyps; Observer Variation; Polyps; Terminology as Topic; World Health Organization
PubMed: 33351878
DOI: 10.5858/arpa.2020-0591-RA -
Journal of Gastroenterology Sep 2023Individual colorectal polyp risk factors are well characterized; however, insights into their pathway-specific interactions are scarce. We aimed to identify the impact...
BACKGROUND
Individual colorectal polyp risk factors are well characterized; however, insights into their pathway-specific interactions are scarce. We aimed to identify the impact of individual risk factors and their joint effects on adenomatous (AP) and serrated polyp (SP) risk.
METHODS
We collected information on 363 lifestyle and metabolic parameters from 1597 colonoscopy participants, resulting in over 521,000 data points. We used multivariate statistics and machine-learning approaches to assess associations of single variables and their interactions with AP and SP risk.
RESULTS
Individual factors and their interactions showed common and polyp subtype-specific effects. Abdominal obesity, high body mass index (BMI), metabolic syndrome, and red meat consumption globally increased polyp risk. Age, gender, and western diet associated with AP risk, while smoking was associated with SP risk. CRC family history was associated with advanced adenomas and diabetes with sessile serrated lesions. Regarding lifestyle factor interactions, no lifestyle or dietary adjustments mitigated the adverse smoking effect on SP risk, whereas its negative effect was exacerbated by alcohol in the conventional pathway. The adverse effect of red meat on SP risk was not ameliorated by any factor, but was further exacerbated by western diet along the conventional pathway. No modification of any factor reduced the negative impact of metabolic syndrome on AP risk, whereas increased fatless fish or meat substitutes' intake mitigated its effect on SP risk.
CONCLUSIONS
Individual risk factors and their interactions for polyp formation along the adenomatous and serrated pathways are strongly heterogeneous. Our findings may facilitate tailored lifestyle recommendations and contribute to a better understanding of how risk factor combinations impact colorectal carcinogenesis.
Topics: Humans; Colonic Polyps; Metabolic Syndrome; Colorectal Neoplasms; Adenoma; Risk Factors; Colonoscopy; Adenomatous Polyps
PubMed: 37300599
DOI: 10.1007/s00535-023-02004-8 -
JCI Insight Nov 2023Germline adenomatous polyposis coli (APC) mutation in patients with familial adenomatous polyposis (FAP) promotes gastrointestinal polyposis, including the formation of...
Germline adenomatous polyposis coli (APC) mutation in patients with familial adenomatous polyposis (FAP) promotes gastrointestinal polyposis, including the formation of frequent gastric fundic gland polyps (FGPs). In this study, we investigated how dysregulated Wnt signaling promotes FGPs and why they localize to the corpus region of the stomach. We developed a biobank of FGP and surrounding nonpolyp corpus biopsies and organoids from patients with FAP for comparative studies. Polyp biopsies and polyp-derived organoids exhibited enhanced Wnt target gene expression. Polyp-derived organoids with intrinsically upregulated Wnt signaling showed poor tolerance to further induction, suggesting that high Wnt restricts growth. Targeted genomic sequencing revealed that most gastric polyps did not arise via APC loss of heterozygosity. Studies in genetic mouse models demonstrated that heterozygous Apc loss increased epithelial cell proliferation in the corpus but not the antrum, while homozygous Apc loss was not maintained in the corpus yet induced hyperproliferation in the antrum. Our findings suggest that heterozygous APC mutation in patients with FAP may be sufficient to drive polyp formation in the corpus region while subsequent loss of heterozygosity to further enhance Wnt signaling is not tolerated. This finding contextualizes the abundant yet benign nature of gastric polyps in FAP patient corpus compared with the rare, yet adenomatous polyps in the antrum.
Topics: Humans; Animals; Mice; Wnt Signaling Pathway; Adenomatous Polyposis Coli; Adenomatous Polyps
PubMed: 37943618
DOI: 10.1172/jci.insight.174546 -
Public Health Reports (Washington, D.C.... 2023Colorectal cancer (CRC) incidence and mortality are twice as high among Alaska Native people as among non-Hispanic White people in the United States; as such,...
OBJECTIVES
Colorectal cancer (CRC) incidence and mortality are twice as high among Alaska Native people as among non-Hispanic White people in the United States; as such, colonoscopy is a recommended screening test for Alaska Native people. Adenoma detection rate (ADR) is measured in patients at average risk of CRC undergoing initial screening colonoscopy and reflects the prevalence of precancerous polyps in a screened population. We evaluated the ADR among Alaska Native people living in Interior Alaska.
METHODS
This project evaluated the ADR among Alaska Native and American Indian adults aged ≥40 years (N = 460) living in Interior Alaska, using a retrospective medical record review of patients referred for screening colonoscopy from February 1, 2018, through March 31, 2022. The main outcome measure was ADR, stratified by age and sex.
RESULTS
The ADR was 45.0% overall: 43.0% among women and 47.1% among men. Among patients aged ≥50 years, the ADR was 67.1%: 62.7% among women and 70.7% among men. Among patients aged 40-49 years, the ADR was 34.4%: 35.3% among women and 33.3% among men.
CONCLUSIONS
Measured ADR was high among Alaska Native men and women aged ≥50 years in Interior Alaska and in all age groups that were screened. These findings have implications for which CRC screening methods, intervals, and age to begin screening are most appropriate for Alaska Native people, as well as the need for future research on the pathology, etiology, and natural history of CRC in this population.
Topics: Adult; Male; Humans; Female; United States; Alaska; American Indian or Alaska Native; Retrospective Studies; Adenomatous Polyps; Colorectal Neoplasms; Adenoma; Early Detection of Cancer
PubMed: 36683459
DOI: 10.1177/00333549221143204 -
European Journal of Gastroenterology &... Feb 2012Osseous metaplasia within the gastrointestinal tract is rare and occurs in benign, premalignant, and malignant neoplasms. Here, we report the youngest case of an... (Review)
Review
Osseous metaplasia within the gastrointestinal tract is rare and occurs in benign, premalignant, and malignant neoplasms. Here, we report the youngest case of an adenomatous polyp with the presence of ossification and a concomitant review of the literature with regard to ossification of colonic polyps. A 28-year-old man underwent colonoscopy for 8 months of rectal bleeding. A 4.5-cm pedunculated polyp was found in the descending colon and excised. Histological examination showed adenomatous change with an area of calcification and osteoid formation. Ossification of colonic polyps is mainly associated with the clinical symptom of bleeding and may warrant consideration as a high-risk feature.
Topics: Adenomatous Polyps; Adult; Calcinosis; Colonic Diseases; Colonic Polyps; Colonoscopy; Humans; Male; Ossification, Heterotopic
PubMed: 22108510
DOI: 10.1097/MEG.0b013e32834e7fd5 -
Seminars in Gastrointestinal Disease Apr 1996Adenomatous polyps of the gastrointestinal tract are dysplastic precursor lesions of adenocarcinoma. The features of an adenoma that are associated with a greater... (Review)
Review
Adenomatous polyps of the gastrointestinal tract are dysplastic precursor lesions of adenocarcinoma. The features of an adenoma that are associated with a greater tendency to progress to carcinoma include larger polyp size, high grade dysplasia, and increased villous glandular architecture. Alterations in particular oncogenes and tumor-suppressor genes have been correlated with various stages of colonic adenoma formation, thereby facilitating our knowledge of adenoma pathogenesis. Heredity and environment contribute to the risk of developing adenomatous polyps of the colon. The incidence of colorectal cancer can be decreased by the endoscopic removal of adenomas, thereby providing good rationale for screening and surveillance programs.
Topics: Adenoma; Adenomatous Polyposis Coli; Adenomatous Polyps; Gastrointestinal Neoplasms; Humans
PubMed: 8705258
DOI: No ID Found -
Gastroenterologia Y Hepatologia Apr 2022
Topics: Adenomatous Polyps; Colon; Colonic Neoplasms; Colonic Polyps; Granular Cell Tumor; Humans
PubMed: 33545239
DOI: 10.1016/j.gastrohep.2020.12.005 -
Revista Espanola de Enfermedades... Aug 2004
Topics: Adenomatous Polyps; Aged; Female; Gallbladder Neoplasms; Humans; Ultrasonography
PubMed: 15449990
DOI: 10.4321/s1130-01082004000800008 -
Gastrointestinal Endoscopy Sep 2009
Topics: Adenomatous Polyps; Biopsy, Needle; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Humans; Immunohistochemistry; Mass Screening; Neoplasm Staging; Sensitivity and Specificity; Tumor Burden
PubMed: 19555943
DOI: 10.1016/j.gie.2009.04.017 -
Gastroenterology Clinics of North... Dec 1988Adenomatous polyps are the benign precursors of colorectal adenocarcinoma. Colonic adenomas occur commonly in adults in Western countries. There is recent evidence that... (Review)
Review
Adenomatous polyps are the benign precursors of colorectal adenocarcinoma. Colonic adenomas occur commonly in adults in Western countries. There is recent evidence that inheritance may play an important role in the etiology of these adenomatous polyps. Colonic adenomatous polyposis (numerous colonic adenomas) is the central feature of several rare inherited syndromes that give rise to colorectal cancer. There also appears to be a risk of gastrointestinal and other malignancies in the rare inherited syndromes of hamartomatous polyposis.
Topics: Adenomatous Polyposis Coli; Adult; Colonic Polyps; Colorectal Neoplasms; Female; Humans; Intestinal Polyps; Male; Middle Aged; Polyps
PubMed: 2852640
DOI: No ID Found