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Clinicopathological Study of the Serrated Lesion in Early Colorectal Cancer Yutaro Egashira 1 , Hiroshi Akutagawa 1 , Go Edagawa 1 , Mototsugu Fujii 1 , Ken Kawakami 2 , Yosuke Abe 2 , Mitsuyuki Murano 2 , Kazuhide Higuchi 2 1The Department of Pathology, Osaka Medical College, Osaka, Japan 2The Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan Keyword: 大腸鋸歯状病変 , 早期大腸癌 , 鋸歯状腺腫 , sessile serrated polyp , sessile serrated adenoma pp.1911-1923
Published Date 2008/12/25
DOI https://doi.org/10.11477/mf.1403101535
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 We investigated 604 early colorectal cancers(intramucosal cancer ; 300 lesions, submucosally invasive cancer ; 304 lesions)to estimate the significance of the serrated lesion in the development of colorectal cancer. Serrated lesions were classified into the following four categories. ① Hyperplastic polyp(HP), ② Sessile serrated polyp/Sessile serrated adenoma(SSP), ③ Traditional serrated adenomas(TSA), ④ Serrated adenocarcinoma(SAD).

 In intramucosal cancer, the incidence of HP, SSP, TSA and SAD were 31.3%, 2.0%, 12.7% and 5.3%, respectively. In submucosally invasive cancer, the incidence of HP, SSP, TSA and SAD were 43.4%, 1.0%, 9.2% and 4.9%, respectively. All lesions with SSP were located in the proximal colon. Lesions with TSA tended to be located in the distal colon and rectum. Gastric-type mucin in the serrated component was detected in all lesions with SSP and TSA, but the incidence of gastric-type mucin decreased in the carcinoma component.

 Among all early colorectal cancers,84 lesions(13.9%)were accompanied with SSP,TSA, or SAD. Therefore, it is thought that the serrated pathway when development of colorectal cancer accounts for a ratio that we cannot ignore. However, there are many problems involved in the colorectal serrated lesions that are not yet solved. For example the unification of the term or the establishment of the diagnostic criteria. Further study using the molecular biologic method will be necessary in the future.


Copyright © 2008, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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