Sessile serrated lesions with dysplasia: is it possible to nip them in the bud?

TitleSessile serrated lesions with dysplasia: is it possible to nip them in the bud?
Publication TypeJournal Article
Year of Publication2023
AuthorsUtsumi T, Yamada Y, Diaz-Meco MTeresa, Moscat J, Nakanishi Y
JournalJ Gastroenterol
Date Published2023 Aug
KeywordsAnimals, Colonic Neoplasms, Colonic Polyps, Colonoscopy, Colorectal Neoplasms, Disease Progression, Mice, Tumor Microenvironment

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.

Alternate JournalJ Gastroenterol
PubMed ID37219625
PubMed Central IDPMC10366009
Grant List23719768 / / Fusion Oriented REsearch for disruptive Science and Technology /
21H02902 / / Japan Society for the Promotion of Science /
22K21080 / / Japan Society for the Promotion of Science /
Related Faculty: 
Maria Diaz-Meco Conde, Ph.D. Jorge Moscat, Ph.D.

Pathology & Laboratory Medicine 1300 York Avenue New York, NY 10065 Phone: (212) 746-6464
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