Title:Colorectal Serrated Lesions: A Current View on Clinical, Morphological,
Molecular, and Genetic Diagnostic Criteria
Volume: 28
Issue: 41
Author(s): Liudmila M. Mikhaleva*, Rositsa A. Vandysheva, Konstantin Yu. Midiber, Olesya A. Vasyukova, Valentina V. Pechnikova, Olga I. Patsap, Ozal Beylerli, Siva G. Somasundaram, Cecil E. Kirkland and Gjumrakch Aliev
Affiliation:
- Research Institute of Human Morphology, 3 Tsyurupy Street, Moscow, 117418, Russian Federation
- Department
of Pathology, City Clinical Hospital #31, 42, Lobachevskiy str, Moscow, 117415, Russian Federation
Keywords:
Serrated colorectal lesions, neoplasm, colon, appendix, morphological criteria, immunohistochemical profile.
Abstract:
Objective: Serrated colorectal lesions are a group of colonic lesions with a serrated
(saw-tooth) profile of the surface epithelium and crypts, and peculiar molecular and
genetic developmental mechanisms that are incompletely understood. These formations
cause concern due to their premalignant potential.
Aim: The review is dedicated to serrated lesions of colon and appendix. We focused on
modern classification, role in carcinogenesis, as well as new approaches to morphological
diagnosis.
Methods: A literature search was performed using PubMed, Scopus, ResearchGate, Google,
MEDLINE, and ScienceDirect databases to find studies of serrated colorectal lesions
related cancer published between 2000 and 2020 that address epidemiological risk factors,
underlying pathophysiological mechanism and enable our review of these factors as
well as molecular, genetics, and structural patterns.
Results: Serrated colorectal lesions take one third of all benign neoplasms of the colon in
the pathologist’s practice. The active study of serrated lesions began in the 1900s. Terminology
and diagnostic criteria changed in the updated classification in 2019. Morphological
criteria, immunohistochemical and molecular profile, endoscopic and clinical characteristics
are reviewed.
Conclusion: Although significant efforts were made in attempt to improve our understanding
and diagnostic criteria of serrated polyps of colorectum, very little has changed
since the original morphologic description of preneoplastic serrated lesions in early
2000s. There remains a need for more research in order to develop more definitive immuophenotypic
and molecular biomarkers in order to distinguish between non-neoplastic
and neoplastic serrated lesions.
