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Arquivos de Medicina
On-line version ISSN 2183-2447
Abstract
AZEVEDO, Sérgio Agostinho Xavier. The role of the serrated pathway in the colorectal carcinogenesis. Arq Med [online]. 2011, vol.25, n.5-6, pp.205-212. ISSN 2183-2447.
Colorectal carcinoma is one of the most common malignant neoplasms in terms of incidence and mortality in Portugal and the Western World. Multiple molecular mechanisms are associated with sporadic colorectal carcinogenesis, including chromosomal instability, microsatellite instability and, more recently, epigenetic instability (also called ciMP phenotype). From the morphological point of view are considered two main pathways, adenomatous and serrated, respectively associated with chromosomal instability and microsatellite instability (with or without ciMP phenotype). This paper reviews the morphological and molecular characteristics of the precursor lesions of serrated pathway (hyperplastic polyps, sessile serrated adenomas/ polyps, traditional serrated adenomas/ polyps, mixed polyps), the relationship between these lesions and colorectal carcinoma and practical implications for screening and treatment of patients.
Keywords : adenoma/adenomatous polyp; serrated pathway; hyperplastic polyp; sessile serrated adenoma/polyp; traditional serrated adenoma/polyp; colorectal neoplasms.