Advertisement

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

Abstract

Background

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.

Aims

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

Methods

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.

Results

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).

Conclusions

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.

Keywords

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

Notes

Conflict of interest

None.

References

  1. 1.
    Kuhajda FP, Jenner K, Wood FD, et al. Fatty acid synthesis: a potential selective target for antineoplastic therapy. Proc Natl Acad Sci. 1994;91:6379–6383.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Menendez JA, Lupu R. Fatty acid synthase and the lipogenic phenotype in cancer pathogenesis. Nat Rev Cancer. 2007;7:763–777.PubMedCrossRefGoogle Scholar
  3. 3.
    Nomura DK, Long JZ, Niessen S, Hoover HS, Ng SW, Cravatt BF. Monoacylglycerol lipase regulates a fatty acid network that promotes cancer pathogenesis. Cell. 2010;140:49–61.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Straub BK, Herpel E, Singer S, et al. Lipid droplet-associated PAT-proteins show frequent and differential expression in neoplastic steatogenesis. Mod Pathol. 2010;23:480–492.PubMedCrossRefGoogle Scholar
  5. 5.
    Sano Y, Ikematsu H, Fu KI, et al. Meshed capillary vessels by use of narrow-band imaging for differential diagnosis of small colorectal polyps. Gastrointest Endosc. 2009;69:278–283.PubMedCrossRefGoogle Scholar
  6. 6.
    Kanao H, Tanaka S, Oka S, Hirata M, Yoshida S, Chayama K. Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors. Gastrointest Endosc. 2009;69:631–636.PubMedCrossRefGoogle Scholar
  7. 7.
    Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy. 2009;41:462–467.PubMedCrossRefGoogle Scholar
  8. 8.
    Ezoe Y, Muto M, Uedo N, et al. Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer. Gastroenterology. 2011;141:2017–2025.PubMedCrossRefGoogle Scholar
  9. 9.
    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.PubMedCrossRefGoogle Scholar
  10. 10.
    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.PubMedCrossRefGoogle Scholar
  11. 11.
    Tanaka M, Usuda K, Ookura Y, et al. Significance of magnifying endoscopy in diagnosis of duodenal elevated lesions [in Japanese with English abstract] Stomach Intestine 2003;38:1709–1720.Google Scholar
  12. 12.
    Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy. 2005;37:570–578.CrossRefGoogle Scholar
  13. 13.
    Hamilton SR, Aaltonen LA, eds. World Health Organization classification of tumours: pathology and genetics of tumours of the digestive system. Lyon: IARC Press; 2000:104–119.Google Scholar
  14. 14.
    Wada Y, Kashida H, Kudo S, Misawa M, Ikehara N, Hamatani S. Diagnostic accuracy of pit pattern and vascular pattern analysis in colorectal lesions. Dig Endosc. 2010;22:192–199.PubMedCrossRefGoogle Scholar
  15. 15.
    Hisabe T, Yao K, Beppu T, et al. Validity of the usefulness of microvascular architecture and microsurface structure using magnifying endoscopy with narrow-band imaging in the colorectal neoplasm. Ann Gastroenterol. 2013;26:45–51.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Hayashi N, Tanaka S, Hewett DG, et al. Endoscopic prediction of deep submucosal invasive carcinoma: validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) classification. Gastrointest Endosc. 2013;78:625–632.Google Scholar
  17. 17.
    Ueo T, Yonemasu H, Yada N, et al. White opaque substance represents an intracytoplasmic accumulation of lipid droplets: immunohistochemical and immunoelectron microscopic investigation of 26 cases. Dig Endosc. 2013;25:147–155.PubMedCrossRefGoogle Scholar
  18. 18.
    Warburg O. On the origin of cancer cells. Science. 1956;123:309–314.PubMedCrossRefGoogle Scholar
  19. 19.
    Benjamin DI, Cravatt BF, Nomura DK. Global profiling strategies for mapping dysregulated metabolic pathways in cancer. Cell Metab. 2012;16:565–577.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Mutoh M, Komiya M, Teraoka N, et al. Overexpression of low-density lipoprotein receptor and lipid accumulation in intestinal polyps in min mice. Int J Cancer. 2009;125:2505–2510.PubMedCrossRefGoogle Scholar
  21. 21.
    Heiden MGV, Cantly LC, Thompson CB. Understanding the Warburg effect: the metabolic requirements of cell proliferation. Science. 2009;324:1029–1033.CrossRefGoogle Scholar
  22. 22.
    Ropert A, Cherbut C, Rozé C, et al. Colonic fermentation and proximal gastric tone in humans. Gastroenterology. 1996;111:289–296.PubMedCrossRefGoogle Scholar
  23. 23.
    Hawkins N, Norrie M, Cheong K, et al. CpG island methylation in sporadic colorectal cancers and its relationship to microsatellite instability. Gastroenterology. 2002;122:1376–1387.PubMedCrossRefGoogle Scholar
  24. 24.
    Samowitz WS, Curtin K, Ma KN, et al. Prognostic significance of p53 mutations in colon cancer at the population level. Int J Cancer. 2002;99:597–602.PubMedCrossRefGoogle Scholar
  25. 25.
    An B, Kondo Y, Okamoto Y, et al. Characteristic methylation profile in CpG island methylator phenotype-negative distal colorectal cancers. Int J Cancer. 2010;127:2095–2105.PubMedCrossRefGoogle Scholar
  26. 26.
    Aaltonen LA, Peltomäki P, Mecklin JP, et al. Replication errors in benign and malignant tumors from hereditary nonpolyposis colorectal cancer patients. Cancer Res. 1994;54:1645–1648.PubMedGoogle Scholar
  27. 27.
    Leggett B, Whitehall V. Role of the serrated pathway in colorectal cancer pathogenesis. Gastroenterology. 2010;138:2088–2100.PubMedCrossRefGoogle Scholar
  28. 28.
    Matsubara J, Honda K, Ono M, et al. Replication errors in benign and malignant tumors from hereditary nonpolyposis colorectal cancer patients. Cancer Epidemiol Biomarkers Prev. 2011;20:2195–2203.PubMedCrossRefGoogle Scholar

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

Personalised recommendations