Figure 5.

Serrated pathway. This diagram shows the chronological changes that occur during the development of neoplasia. MAPK mutations do not affect just one gene; rather, they affect some genes more than others. Gene methylation is successive rather than simultaneous and contributes to the progression of the serrated lesion. Depending on which genes are most affected, serrated cancers can be classified into three subtypes. GCHP: Goblet-cell hyperplastic polyp; MVHP: Microvesicular hyperplastic polyp; SSA: Sessile serrated adenoma; TSA: Traditional serrated adenoma.