Colonic Hyperplastic Polyp: Causes, Remedies, and Prognosis
In the human digestive system, hyperplastic polyps are benign growths that form along the inner lining of the colon and rectum. These polyps are a common finding during colonoscopies, and while they are generally not cancerous, it's essential to understand their characteristics and potential risks.
Hyperplastic polyps can be divided into three main types: mucin-poor, goblet cell-rich, and microvesicular serrated polyps. The latter, microvesicular serrated polyps, have a mix of column-like cells and goblet cells.
Typical hyperplastic polyps, usually small and found predominantly in the distal colon (rectosigmoid region), are generally considered benign with very low or no malignant potential. In contrast, sessile serrated lesions/polyps (SSLs/SSPs) and traditional serrated adenomas (TSAs) are of concern, as they show mutations and molecular changes linked with early steps toward colorectal cancer.
Some of the key mutations and molecular alterations associated with precancerous serrated polyps include BRAF mutations, CpG island methylator phenotype (CIMP), MLH1 promoter hypermethylation, and immune changes. These alterations can lead to a higher risk of cancer, especially when multiple serrated colonic hyperplastic polyps are present.
It's important to note that adenomatous polyps (non-serrated), such as tubular, tubulovillous, and villous adenomas, are a separate class known for their precancerous potential but are distinct from hyperplastic and serrated polyps.
Regarding the removal of hyperplastic polyps, doctors may choose to remove them if the polyp is larger than a certain size or if a person has multiple polyps. This procedure can be done during a colonoscopy, where doctors use a flexible tube with a camera, light, and a small metal hoop to burn or cut off the polyps.
While hyperplastic polyps themselves are generally not precancerous, anyone experiencing symptoms such as mucus or blood in stool, constipation, diarrhea, or stomach pain should contact a doctor. Additionally, people with risk factors such as a high-fat, low-fiber diet, smoking, excessive alcohol consumption, a family history of polyps, intestinal polyposis, or colorectal cancer, and aging should be mindful and consider regular screenings.
In summary, while typical hyperplastic polyps are generally benign, sessile serrated lesions and traditional serrated adenomas can pose a higher risk of cancer due to their associated mutations and molecular changes. Adenomatous polyps, on the other hand, are a separate class with precancerous potential. Regular screenings and a healthy lifestyle can help manage the risks associated with hyperplastic polyps.
| Polyp Type | Location Typical | Cancer Risk | Mutations/Alterations | |--------------------------|------------------|--------------------|----------------------------------------------------------| | Typical Hyperplastic Polyps (HPs) | Distal colon | Very low/none | Usually no driver mutations, stable | | Sessile Serrated Lesions/Polyps (SSLs) | Proximal colon | Precancerous | BRAF mutation, CIMP, MLH1 hypermethylation, immune changes| | Traditional Serrated Adenomas (TSAs) | Variable | Precancerous | Similar serrated pathway mutations |
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