Sessile serrated lesions with dysplasia: is it possible to nip them in the bud?
Classification
SSL
SSLD
Serrated pathway
Tumor microenvironment
Journal
Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
23
03
2023
accepted:
14
05
2023
medline:
27
7
2023
pubmed:
23
5
2023
entrez:
23
5
2023
Statut:
ppublish
Résumé
The serrated neoplasia pathway constitutes an "alternative route" to colorectal cancer (CRC), and sessile serrated lesions with dysplasia (SSLDs) are an intermediate step between sessile serrated lesions (SSLs) and invasive CRC in this pathway. While SSLs show indolent growth before becoming dysplastic (> 10-15 years), SSLDs are considered to rapidly progress to either immunogenic microsatellite instable-high (MSI-H) CRC (presumably 75% of cases) or mesenchymal microsatellite stable (MSS) CRC. Their flat shapes and the relatively short window of this intermediate state make it difficult to detect and diagnose SSLDs; thus, these lesions are potent precursors of post-colonoscopy/interval cancers. Confusing terminology and the lack of longitudinal observation data of serrated polyps have hampered the accumulation of knowledge about SSLDs; however, a growing body of evidence has started to clarify their characteristics and biology. Together with recent efforts to incorporate terminology, histological studies of SSLDs have identified distinct dysplastic patterns and revealed alterations in the tumor microenvironment (TME). Molecular studies at the single-cell level have identified distinct gene alterations in both the epithelium and the TME. Mouse serrated tumor models have demonstrated the importance of TME in disease progression. Advances in colonoscopy provide clues to distinguish pre-malignant from non-malignant-SSLs. Recent progress in all aspects of the field has enhanced our understanding of the biology of SSLDs. The aim of this review article was to assess the current knowledge of SSLDs and highlight their clinical implications.
Identifiants
pubmed: 37219625
doi: 10.1007/s00535-023-02003-9
pii: 10.1007/s00535-023-02003-9
pmc: PMC10366009
doi:
Types de publication
Review
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
705-717Subventions
Organisme : Fusion Oriented REsearch for disruptive Science and Technology
ID : 23719768
Organisme : Japan Society for the Promotion of Science
ID : 21H02902
Organisme : Japan Society for the Promotion of Science
ID : 22K21080
Informations de copyright
© 2023. The Author(s).
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