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要旨●鋸歯状病変は過形成性ポリープ(HP),鋸歯状腺腫(TSA),SSA/Pに大別される.しかし,各疾患に必ずしも当てはまらない中間型も存在する.SSA/Pはマイクロサテライト不安定性(MSI)大腸癌と類似した分子病態,すなわちBRAF変異やCpGアイランドの同時多発的なメチル化(CIMP)などの特徴的な分子異常を有し,特異的な内視鏡所見として開II型pitが明らかとなっている.一方でTSAや中間型の分子異常は多様であり,また臨床病理像も不明な点が多く,今後の課題である.
Serrated lesions include HP(hyperplastic polyp), TSA(traditional serrated adenoma), and SSA/P(sessile serrated adenoma/polyp). However, in this manuscript, some serrated lesions did not satisfy the criteria of these three categories and were defined as intermediate type. SSA/Ps are known to be closely associated with BRAF mutation and the CIMP(CpG island methylator phenotype); this suggests that SSA/Ps are precursors of CRCs(colorectal cancers), with MSI(microsatellite instability). Type II-O(Type II open-pit pattern)was specific to SSA/Ps with BRAF mutation and CIMP. However, molecular and clinical features of TSAs and intermediate type SSA/Ps remain unclear.
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