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DOI: 10.1055/a-1452-9669
Nature of a white opaque substance visualized by magnifying endoscopy in colorectal hyperplastic polyps[*]
Abstract
Background and study aims A white opaque substance (WOS) has been observed in the epithelia of gastric, duodenal, and colorectal epithelial adenomas and carcinomas, using magnifying endoscopy (ME). The WOS has been reported to be derived from a dense accumulation of minute lipid droplets in the epithelium. This study aimed to investigate whether the WOS in colorectal hyperplastic polyps was derived from lipid droplets accumulated in the epithelium, as observed in the case of gastric, duodenal, and colorectal epithelial neoplasms.
Patients and methods We analyzed 30 consecutive patients who were positive for the WOS, as visualized in colorectal hyperplastic polyps by ME with narrow-band imaging and 30 consecutive patients who were negative for the WOS. Biopsy specimens obtained from the polyps were immunostained with anti-adipophilin antibody to determine the correlation between the presence of the WOS and that of lipid droplets in the epithelium.
Results In all patients, the epithelial cells were histologically positive for adipophilin. However, the area of adipophilin-positive epithelial cells in the WOS-positive group was significantly larger than that in the WOS-negative group (P < 0.001). The density of the WOS was strongly and positively correlated with the area of adipophilin-positive cells.
Conclusions This study reveals that the WOS visualized in the superficial layers of colorectal hyperplastic polyps is produced by a dense accumulation of minute lipid droplets in the epithelia of the polyps.
* Meeting presentations: Asian Pacific Digestive Week 2019
Publication History
Received: 17 November 2020
Accepted: 23 February 2021
Article published online:
17 June 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Yao K, Iwashita A, Tanabe H. et al. White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow- band imaging: a new optical sign for differentiating between adenoma and carcinoma. Gastrointest Endosc 2008; 68: 574-580
- 2 Tanaka M, Usuda K, OOkura Y. et al. Significance of magnifying endoscopy in diagnosis of duodenal elevated lesions [in Japanese with English abstract]. Stomach and Intestine 2003; 38: 1709-1720
- 3 Tsuji S, Doyama H, Tshuji K. et al. Magnifying endoscopy with narrow band imaging for superficial non-ampullary duodenal epithelial tumors before biopsy [in Japanese with English abstract]. Stomach and Intestine 2016; 68: 574-580
- 4 Hisabe T, Yao K, Imamura K. et al. White opaque substance visualized using magnifying endoscopy with narrow-band imaging in colorectal epithelial neoplasms. Dig Dis Sci 2014; 59: 2544-2549
- 5 Yao K, Iwashita A, Nambu M. et al. Nature of white opaque substance in gastric epithelial neoplasia as visualized by magnifying endoscopy with narrow-band imaging. Dig Endosc 2012; 24: 419-425
- 6 Imamura K, Yao K, Hisabe T. et al. The nature of the white opaque substance within colorectal neoplastic epithelium as visualized by magnifying endoscopy with narrow-band imaging. Endosc Int Open 2016; 04: E1151-E1157
- 7 Hisabe T, Yao K, Imamura K. et al. Novel endoscopic findings as visualized by magnifying endoscopy with narrow-band imaging: white opaque substance is present in colorectal hyperplastic polyps. Digestion 2016; 93: 127-131
- 8 Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy 2009; 41: 462-467
- 9 Hewett DG, Kaltenbach T, Sano Y. et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143: 599-607
- 10 Ohtsu K, Yao K, Matsunaga M. et al. Lipid is absorbed in the stomach by epithelial neoplasms (adenomas and early cancers): a novel functional endoscopy technique. Endosc Int Open 2015; 03: E318-E322
- 11 Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in digestive tract. Endoscopy 2005; 37: 570-578
- 12 Snover DC, Ahnen DJ, Burt RW. et al. Serrated polyps of the colon and rectum and serreted polyposis. Bosman FT, Carneriro F, Hruban RH. et al. World Health Organization Classification of Tumours of the Digestive System. Lyon: IARC Press; 2010: 160-165
- 13 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174
- 14 Heid HW, Moll R, Scchetlick I. et al. Adipophilin is a specific marker of lipid accumulation in diverse cell types and disease. Cell Tissue Res 1998; 294: 309-321
- 15 Sano Y, Horimatsu T, Fu KI. et al. Magnifying observation of microvascular architecture of colorectal lesions using a narrow-band imaging system. Dig Endosc 2006; 18: 44-51
- 16 Kawasaki K, Kurahara K, Yanai S. et al. Significance of a white opaque substance under magnifying narrow-band imaging colonoscopy for the diagnosis of colorectal epithelial neoplasms. Gastrointest Endosc 2015; 82: 1097-1104