What influences preneoplastic colorectal lesion recurrence

// Giulia De Maio 1 , Elisa Zama 1 , Claudia Rengucci 1 , Daniele Calistri 1 1 Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy Correspondence to: Daniele Calistri, email: daniele.calistri@irst.emr.it Keywords: recurrence, preneoplastic lesions, suppressor and serrated pathway, microbiota Received: August 02, 2016      Accepted: November 15, 2016      Published: November 25, 2016 ABSTRACT The hypothesis of the local recurrence of preneoplastic lesions was first put forward in the 1950s. Disease recurrence may result from an inherent imbalance in cell proliferation that promotes carcinogenesis in apparently normal mucosa. Our review sheds light on how early preneoplastic lesions could be used to diagnose relapsed preneoplastic and, developing neoplastic lesions. We focus in detail on the clinical-pathological and molecular features of adenoma subtypes and their role in relapsed adenoma and their development into colorectal carcinoma. Moreover, we include the data available on microbiota and its metabolites and their role in recurrence. We strongly believe that a significant improvement could be achieved in colorectal screening by introducing personalized endoscopic surveillance for polyp-bearing patients on the basis of the presence of molecular markers that are predictive of recurrence.