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要旨 従来,単に非腫瘍性病変と考えられていた過形成性ポリープ(hyperplastic polyp;HP)の概念は変遷し,TSA(traditional serrated adenoma)への移行やSSA/P(sessile serrated adenoma/polyp)を介して癌化する可能性があることがわかってきた.HPとSSA/Pは病理学的に明瞭に分けられ,SSA/Pのみを治療することが理想的であるが,実際の臨床において,両者の鑑別を内視鏡検査中にリアルタイムで行うことは,現状では困難である.そのため,HPおよびSSA/Pの治療は,病変の部位(右側,左側)と大きさで決定するのが簡便で実用的であり,具体的な治療指針を提示したい.
The concept of classical HP(hyperplastic polyp)considered as non-neoplastic polyp has changed during the last several decades. It has been found that classical HP includes lesions with malignant potential and they have been defined as SSA/P(sessile serrated polyp/adenoma). If we could resect only SSA/P, it would be ideal. Unfortunately, so far, it has been difficult to differentiate SSA/P(neoplastic)from HP(non-neoplastic)during real-time colonoscopy. We have proposed a simple treatment strategy for SSA/P and HP made by their size and location.
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