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| 1 | 伴或不伴细胞异型的结直肠无蒂锯齿状腺瘤/息肉与增生性息肉的内镜下特征比较显示文摘目的比较结直肠无蒂锯齿状腺瘤/息肉(SSA/P)与增生性息肉(HP)在白光内镜和图像增强模式(IEE)下的形态特征。方法回顾性分析2016年8月1日至2018年2月29日于北京大学国际医院内镜中心接受结肠镜检查的7 384例患者的临床资料。对白光+IEE[内镜智能分光比色技术(FICE)或蓝激光成像技术(BLI)]下,SSA/P与HP、SSA/P伴细胞异型(SSA/P-CD^+)与SSA/P不伴细胞异型(SSA/P-CD^-)的形态特征进行比较;分析内镜下形态特征对SSA/P、SSA/P-CD^+的诊断价值。结果7 384例患者共检出息肉3 401枚。其中,SSA/P 164枚(135例患者),对照组HP 270枚(223例患者)。与HP组相比,SSA/P以右半结肠、直径>5 mm多见,多表现为Ⅱ-O型腺管开口、表面黏液、积云样表面、形态不规则、曲张微血管、颜色发红,更易合并其他部位结肠腺瘤、结肠癌,差异有统计学意义(P<0.01)。与SSA/P-CD^-组相比,SSA/P-CD^+组以右半结肠、直径>5 mm多见,多表现为Ⅱ-O型腺管开口、表面黏液、积云样表面、形态不规则、曲张微血管,差异有统计学意义(P<0.001)。联合上述任意两项内镜下形态特征,对SSA/P进行诊断:灵敏度:59.15%,特异度:95.56%,准确性:81.80%,阳性似然比:13.32,阴性似然比:0.43;对SSA/P-CD^+进行诊断:灵敏度:92.16%,特异度:95.56%,准确性:95.02%,阳性似然比:20.76,阴性似然比:0.08。结论通过观察病变在白光和FICE/BLI模式下的形态特征,可有效区分SSA/P与HP,特别是SSA/P-CD^+与HP。 | 王妍 任玉波 杨雪松 黄永辉 张蕾 李欣 白鹏 王丽 范雪 丁一鸣 李海龙 林香春 | 2019 | 中华医学杂志2019，99，28： | 13 |
| 2 | Serrated pathway in colorectal carcinogenesis显示文摘Serrated adenocarcinoma is a recently described subset of colorectal cancer(CRC),which account for about10%of all CRCs and follows an alternative pathway in which serrated polyps replace the traditional adenoma as the precursor lesion to CRC.Serrated polyps form a heterogeneous group of colorectal lesions that includes hyperplastic polyps(HPs),sessile serrated adenoma(SSA),traditional serrated adenoma(TSA)and mixed polyps.HPs are the most common serrated polyp followed by SSA and TSA.This distinct histogenesis is believed to have a major influence in prevention strategies,patient prognosis and therapeutic impact.Genetically,serrated polyps exhibited also a distinct pattern,with KRAS and BRAF having an important contribution to its development.Two other molecular changes that have been implicated in the serrated pathway include microsatellite instability and the CpG island methylator phenotype.In the present review we will address the current knowledge of serrated polyps,clinical pathological features and will update the most recent findings of its molecular pathways.The understanding of their biology and malignancy potential is imperative to implement a surveillance approach in order to prevent colorectal cancer development. | Letícia Yamane Cristovam Scapulatempo-Neto Rui Manuel Reis Denise Peixoto Guimares | 2014 | World Journal of Gastroenterology2014，20，10： | 8 |
| 3 | 结直肠锯齿状病变临床病理学诊断进展显示文摘锯齿状病变是一组以上皮呈锯齿状结构为特征的结直肠息肉/腺瘤,具有恶变为腺癌的潜能,近年来锯齿状病变日益受到临床病理学及分子遗传学工作者的关注。虽然国外对锯齿状病变的了解与研究开展较早,但其发病机制和癌变机制尚不明确,我国多数病理医师及临床医师对其更是鲜有认识。2010年WHO消化系统肿瘤分类对结直肠锯齿状息肉及息肉病进行了较为详细的临床病理学及分子遗传学介绍。本文结合WHO(2010)消化系统肿瘤分类的介绍,以锯齿状病变的病理学特征为主,从流行病学特征和危险因素、组织特点和诊断标准、癌变机制、免疫组化特征以及预后几个方面对该病变进行综述,旨在增强对锯齿状病变的认识。 | 王琳 王鲁平 | 2011 | 诊断病理学杂志2011，18，4： | 5 |
| 4 | Serrated pathway:Alternative route to colorectal cancer显示文摘Serrated polyps have been an area of intense focus for gastroenterologists over the past several years. Contrary to what was thought before,a growing body of literature indicates that these polyps can be precursors of colorectal cancer(CRC).Most of these lesions, particularly those in the proximal colon,have so far been under-recognized and missed during colonoscopy,qualifying these lesions to be the main cause of interval cancers.It is estimated that 10%-20%of CRCs evolve through this alternative,serrated pathway, with a distinct genetic and epigenetic profile.Aberrant DNA methylation plays a central role in the development of this CRC subtype.This characteristic molecular background is reflected in a unique pathological and clinical manifestation different from cancers arising via the traditional pathway.In this review we would like to highlight morphological,molecular and clinical features of this emerging pathway that are essential for gastroenterologists and may influence their everyday practice. | rpád V Patai Béla Molnár Zsolt Tulassay Ferenc Sipos | 2013 | World Journal of Gastroenterology2013，19，5： | 4 |
| 5 | 结直肠无蒂锯齿状腺瘤的筛检及临床处理策略探讨显示文摘近年来提出的“锯齿状癌变途径”是一条受到广泛重视的结直肠癌(colorectal callcer,CRC)癌变通路[1]。锯齿状息肉主要包括增生性息肉(hyperplastic polyp,HP)、无蒂锯齿状腺瘤(sessile serrated adenoma,ssA)和传统锯齿状腺瘤(tra—ditional serrated adenoma,TSA)。SSA是新近发现的、具有高危恶变倾向的病变,与右半结肠CRC密切相关[2-3]。SSA的早期检出和正确处理是阻止其进展及癌变的重要途径,但目前尚缺乏统一的诊断标准及处理策略[3]。 | 邱野 付祥胜 彭燕 | 2014 | 中华消化内镜杂志2014，31，3： | 3 |
| 6 | 结直肠锯齿状腺瘤研究进展显示文摘结直肠癌的发病率在全球范围内呈上升趋势,目前已成为病死率居第三的癌症.结肠镜检查的普及有助于结直肠癌的早期诊断和治疗,但近年来近端结肠癌的病死率未明显改变[1].我国的调查显示,在20世纪80年代时左半结肠癌和右半结肠癌的发病率无明显差异,但在21世纪初时右半结肠癌的发病率明显上升[2].有研究认为,近端结肠癌与远端结肠癌发病率存在差异的原因之一可能是在结肠镜筛查中对锯齿状腺瘤(serrated adenoma,SA)的认识不足[3-4].与传统腺瘤的突变途径不同,SA有着特殊的锯齿状通路[5]. | 赵宇 林香春 司空银河 刘揆亮 | 2014 | 中华消化杂志2014，34，11： | 2 |
| 7 | 简述广基锯齿状腺瘤的特点及内镜下形态学表现显示文摘近年来,广基锯齿状腺瘤逐渐受到人们重视,Urbanski等首先报道了这类病变,1990年Longacre和Fenoglio—Preiser系统研究了这种特殊类型的息肉并将其命名为混合型增生性腺瘤样息肉(mixedhyperplasticadenomatouspolyps,MHAP)/锯齿状腺瘤(serratedadenoma),后被简称为锯齿状腺瘤。 | 张澍田 | 2016 | 中国医刊2016，51，1： | 0 |
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