鋸歯状腺癌の定義と臨床病理学的特徴

Definition and Clinicopathologic Characteristics of Serrated Adenocarcinoma

要旨●大腸の鋸歯状腺癌はWHO分類に記載されているが，その診断基準が問題である．Mäkinenは8つの特徴的所見による鋸歯状腺癌の定義を提唱しているが，この定義に従った症例を用いた報告においても，さまざまな鋸歯状構造を示す腺癌が含まれているようで，悪性度や予後，分子生物学的特徴も報告により一定でない．鋸歯状腺癌は一つの組織亜型として意義があるように思われるが，比較的簡便で客観的な病理診断基準の確立が今後の課題である．

　Although SAC（serrated adenocarcinoma）of the large intestine is listed in the World Health Organization classification, its diagnostic criteria are still controversial. Mäkinen proposed a definition of SAC based on eight characteristics, and adenocarcinoma showing various serrated structures seems to be included even in case reports based on this definition. However, previous studies reported inconsistent malignancy, prognosis, and molecular biological characteristics. Although SAC seems to be a significant histological subtype, comparatively simple and objective histological diagnostic criteria should be established in the future.