Alert: colorectal polyps with cancer potential!

With the increasing incidence of colorectal cancer in our country, people pay more and more attention to the main precancerous disease. Trad


With the increasing incidence of colorectal cancer in our country, people pay more and more attention to the main precancerous disease. Traditionally, adenomatous polyps are precancerous, while others are benign. However, in recent years, it has been proved that some hyperplastic polyps and serrated adenomatous polyps also have obvious canceration tendency. This paper briefly discusses the clinical problems of hyperplastic polyps, serrated polyps and hamartomatous polyposis syndrome with malignant potential.

Hyperplastic polyp

Canadian scholar Jia Xi (Jass), discusses the characteristics of hyperplastic polyps, polyps will be divided into two types, one type higher, with serrated adenomatous polyp characteristics with dysplasia.

The American scholar Thor Rakovic (Torlakovic) was analyzed with histological features of hyperplastic polyps and polyps, will be divided into 3 main subtypes, namely vesicular mucin type serrated polyps (MVSP) and goblet cell type serrated polyps (GCSP) and mucin deletion.

There are a large number of columnar cells in the crypts of MVSP, which are rich in microbubbles. In some of the lesions located in the proximal colon, the jagged structure extends downward along the crypt

GCSP and the upper crypt surface is covered with many mature goblet cells, serrated structure is less significant than the former. The results of molecular biology strongly support the classification.

Serrated polyp

Also known as serrated serrated polyps of adenomatous polyps, including aberrant crypt foci, mixed polyps, traditional serrated adenoma (TSA) and sessile serrated adenoma (SAA, including the type of hyperplastic polyps), although they have some common characteristics in morphology, but the difference of molecular biological characteristics significantly. The pathway of carcinogenesis is known as the "zigzag way", different from the traditional adenomatous polyp. The results of the study of serrated polyps are changing the traditional view of the mechanism of colorectal carcinogenesis

1 the traditional serrated adenoma TSA was similar to that of hyperplastic polyps and adenomatous polyps. TSA usually uplift, diameter of syndrome (polyposispig-mentationalopecia-onycholrophiasyndrome Cronkhite-Canada syndrome) polyps, pigmentation, loss of hair and nail dystrophy syndrome may include tubular tissue and mucinous cyst, have certain canceration rate.

6 multiple hamartoma syndrome (Cowden syndrome) is a disease of the gastrointestinal tract polyposis with facial papules, acral keratosis and mastoid lesions of oral mucosa. The age of onset was 13~65 years old, 25 years old to see, male and female ratio of 1: 1.5. 40% with malignant tumors, mainly for breast cancer, thyroid cancer.

Figure 1 dim, sessile, hyperplastic polyp

Figure 2. The proliferation of the mucous glands and the branches are jagged

Figure 3. The upper arrow is a typical adenomatous polyp with a sessile serrated adenoma


Note that, in addition to hamartomatous polyps of adenomatous polyps and more with genetic background, polyposis syndrome, various serrated polyps have canceration tendency. This reminds us that we should not give up because of the "hyperplastic polyps".

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