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Vol. 34. Núm. S2.
Jornada de Actualización en Gastroenterología Aplicada
Páginas 73-77 (Octubre 2011)
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Vol. 34. Núm. S2.
Jornada de Actualización en Gastroenterología Aplicada
Páginas 73-77 (Octubre 2011)
Acceso a texto completo
Pólipos serrados: detección, riesgo de cáncer colorrectal y estrategias de tratamiento y vigilancia
Serrated polyps: detection, risk of colorectal cancer and treatment and surveillance strategies
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5605
Leticia Moreira
Servicio de Gastroenterología, Hospital Clínic, Barcelona, España
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Resumen

Los pólipos hiperplásicos en el colon se han considerado tradicionalmente lesiones benignas sin riesgo de malignización. Sin embargo, los pólipos hiperplásicos son sólo una parte del espectro de los llamados pólipos serrados, que incluyen diferentes subtipos de lesiones con una característica histológica común, la apariencia “en dientes de sierra”, con potencial de transformación a carcinoma colorrectal a través de la llamada “vía serrada”. Por tanto, la identificación y resección de estas lesiones, así como el seguimiento de estos pacientes, es fundamental para la prevención de esta neoplasia. Los estudios presentados este año en el congreso de la American Gastroenterological Association aportan información relevante para caracterizar mejor estas lesiones, particularmente importantes para la prevención del cáncer colorrectal, y establecer programas de vigilancia adecuados.

Palabras clave:
Cáncer colorrectal
Pólipos hiperplásicos
Pólipos serrados
Vía serrada
Vigilancia
Abstract

Hyperplastic polyps of the colon have traditionally been considered benign lesions without risk of progression to malignancy. However, hyperplastic polyps are only part of the spectrum of polyps known as serrated polyps. These polyps, which share a common sawtooth appearance, include distinct subtypes of lesions that can potentially undergo malignant transformation to colorectal carcinoma through the serrated pathway. Therefore, to prevent this process, affected patients must undergo surveillance and lesions must be identified and resected. Studies presented this year at the congress of the American Gastroenterological Association have provided useful information to better characterize these lesions –particularly important for the prevention of colorectal cancer– and to establish appropriate surveillance strategies.

Keywords:
Colorectal cancer
Hyperplastic polyps
Serrated pathway
Serrated polyps
Surveillance
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Bibliografía
[1.]
A. Castells, X. Bessa.
Pólipos y poliposis intestinal.
Tratamiento de las enfermedades gastroenterológicas, pp. 247-256
[2.]
Leggett B, Whitehall V. Role of the serrated pathway in colorectal cancer pathogenesis. Gastroenterology. 138:2088-100.
[3.]
K.J. Spring, Z.Z. Zhao, R. Karamatic, M.D. Walsh, V.L. Whitehall, T. Pike, et al.
High prevalence of sessile serrated adenomas with BRAF mutations: a prospective study of patients undergoing colonoscopy.
Gastroenterology, 131 (2006), pp. 1400-1407
[4.]
M.J. O’Brien.
Hyperplastic and serrated polyps of the colorectum.
Gastroenterol Clin North Am, 36 (2007), pp. 947-968
[5.]
N.S. Goldstein, P. Bhanot, E. Odish, S. Hunter.
Hyperplastic-like colon polyps that preceded microsatellite-unstable adenocarcinomas.
Am J Clin Pathol, 119 (2003), pp. 778-796
[6.]
J.E. East, B.P. Saunders, J.R. Jass.
Sporadic and syndromic hyperplastic polyps and serrated adenomas of the colon: classification, molecular genetics, natural history, and clinical management.
Gastroenterol Clin North Am, 37 (2008), pp. 25-46
[7.]
A. Mojtahed, R. Tonya, Kaltenbach, R. Rouse, A. Teri, Longrace, et al.
Poor agreement between endoscopic and pathologic diagnoses of large serrated polyps and the urgent need for a gold standard.
Gastroenterology, 140 (2011), pp. S411
[8.]
C. Kahi, G. Eckert, D. Rex.
Minimum proximal colon serrated polyp detection rate in average-risk males and females.
Gastrointest Endosc, 73 (2011), pp. AB290
[9.]
C. Kahi, G. Eckert, D. Rex.
True prevalence of proximal colon serrated polyps in average-risk screening patients.
Gastrointest Endosc, 73 (2011), pp. AB291
[10.]
Boparai KS, Mathus-Vliegen EM, Koornstra JJ, Nagengast FM, Van Leerdam M, Van Noesel CJ, et al. Increased colorectal cancer risk during follow-up in patients with hyperplastic polyposis syndrome: a multicentre cohort study. Gut. 59:1094-100.
[11.]
N.J. Hawkins, R.L. Ward.
Sporadic colorectal cancers with microsatellite instability and their possible origin in hyperplastic polyps and serrated adenomas.
J Nat Cancer Inst, 93 (2001), pp. 1307-1313
[12.]
T.L. Chan, W. Zhao, S.Y. Leung, S.T. Yuen.
BRAF and KRAS mutations in colorectal hyperplastic polyps and serrated adenomas.
Cancer Research, 63 (2003), pp. 4878-4881
[13.]
T. Kambara, L.A. Simms, V.L. Whitehall, K.J. Spring, C.V. Wynter, M.D. Walsh, et al.
BRAF mutation is associated with DNA methylation in serrated polyps and cancers of the colorectum.
Gut, 53 (2004), pp. 1137-1144
[14.]
S. Hiraoka, J. Kato, S. Fujiki, E. Kaji, T. Morikawa, T. Murakami, et al.
The presence of large serrated polyps increases risk for colorectal cancer.
Gastroenterology, 139 (2010), pp. 1503-1510
[15.]
M.A. Schreiner, D.G. Weiss, D.A. Lieberman.
Proximal and large hyperplastic and non-dysplastic serrated polyps detected by colonoscopy are associated with neoplasia.
Gastroenterology, 139 (2010), pp. 1497-1502
[16.]
A. Rastogi, N. Gupta, D. Rao, S. Edmundowicz, D. Early, et al.
Association of right sided hyperplastic polyps, large hyperplastic polyps, and other serrated polyps with synchronous colonic neoplasia.
Gastroenterology, 140 (2011), pp. S407
[17.]
A. Teriaky, D. Driman, N. Chande.
Outcomes of a 5 year follow-up of patients with sessile serrated adenomas.
Gastroenterology, 140 (2011), pp. S261
[18.]
V.P. Bauer, H.T. Papaconstantinou.
Management of serrated adenomas and hyperplastic polyps.
Clin Colon Rectal Surg, 21 (2008), pp. 273-279
[19.]
B. Levin, D.A. Lieberman, B. McFarland, R.A. Smith, D. Brooks, K.S. Andrews, et al.
Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps 2008, a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.
CA Cancer J Clin, 58 (2008), pp. 130-160
[20.]
R. Kiesslich, M. Von Bergh, M. Hahn, G. Hermann, M. Jung.
Chromoendoscopy with indigocarmine improves the detection of adenomatous and nonadenomatous lesions in the colon.
Endoscopy, 33 (2001), pp. 1001-1006
[21.]
T. Kaltenbach, S. Friedland, R. Soetikno.
A randomised tandem colonoscopy trial of narrow band imaging versus white light examination to compare neoplasia miss rates.
Gut, 57 (2008), pp. 1406-1412
[22.]
C. Kahi, L. Xiaochun, D. Rex.
Prevalence of proximal serrated polyps detected by high-definition screening colonoscopy in average-risk patients.
Gastrointest Endosc, 73 (2011), pp. AB442
[23.]
D.C. Snover, J.R. Jass, C. Fenoglio-Preiser, K.P. Batts.
Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept.
Am J Clin Pathol, 124 (2005), pp. 380-391
[24.]
J.P. Terdiman, K.R. McQuaid.
Surveillance guidelines should be updated to recognize the importance of serrated polyps.
Gastroenterology, 139 (2010), pp. 1444-1447
[25.]
A. Mojtahed, T. Kaltenbach, R. Rouse, T. Longacre, R. Pai, H. Flaster, et al.
Accurate classification of serrated polyps significantly impacts surveillance colonoscopy recommendations in a large non-polypoid colorectal neoplasm study cohort.
Gastrointest Endosc, 73 (2011), pp. AB289
Copyright © 2011. Elsevier España S.L.. Todos los derechos reservados
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