Digestive Diseases and Sciences

, Volume 59, Issue 10, pp 2544–2549 | Cite as

White Opaque Substance Visualized Using Magnifying Endoscopy with Narrow-Band Imaging in Colorectal Epithelial Neoplasms

  • Takashi Hisabe
  • Kenshi Yao
  • Kentaro Imamura
  • Hiroshi Ishihara
  • Fumihito Hirai
  • Toshiyuki Matsui
  • Akinori Iwashita
Original Article



The presence of a white opaque substance (WOS) on magnifying endoscopy (ME) with narrow-band imaging (NBI) has been reported for gastric epithelial neoplasms, but the presence of WOS in colorectal epithelial neoplasms has not been investigated.


The purpose of this study was to determine whether WOS is present in colorectal epithelial neoplasms and to clarify its clinical significance.


A total of 590 colorectal epithelial neoplasms from 368 consecutive patients were retrospectively analyzed using prospectively collected data. Presence or absence of WOS in colorectal epithelial neoplasms was recorded based on the findings of ME with NBI.


White opaque substance was present in 236 of the 590 (40 %) colorectal epithelial neoplasms. Compared with WOS-negative patients, WOS-positive patients showed significantly larger tumors (p < 0.0001) and significantly more tumors in the proximal colon (p = 0.0003). WOS was more frequently present in carcinomas (66.0 %) than in adenomas (31.8 %; p < 0.0001). WOS was also more frequent in submucosal carcinomas (75.9 %) than in intramucosal carcinomas (59.0 %; p = 0.0380).


This study confirmed the presence of WOS in colorectal epithelial neoplasms, and prevalence increased with the progression of cancer, from adenoma to carcinoma and from intramucosal carcinoma to submucosal carcinoma.


Cancer Colorectal epithelial neoplasm Magnifying endoscopy Narrow-band imaging White opaque substance 


Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Takashi Hisabe
    • 1
  • Kenshi Yao
    • 1
  • Kentaro Imamura
    • 2
  • Hiroshi Ishihara
    • 1
  • Fumihito Hirai
    • 1
  • Toshiyuki Matsui
    • 1
  • Akinori Iwashita
    • 2
  1. 1.Department of GastroenterologyFukuoka University Chikushi HospitalChikushinoJapan
  2. 2.Department of PathologyFukuoka University Chikushi HospitalChikushinoJapan

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