TY - JOUR
T1 - White spots around colorectal tumors are cancer-related findings and may aid endoscopic diagnosis
T2 - a prospective study in Japan
AU - Korekawa, Kai
AU - Shimoyama, Yusuke
AU - Fujishima, Fumiyoshi
AU - Nagai, Hiroshi
AU - Naito, Takeo
AU - Moroi, Rintaro
AU - Shiga, Hisashi
AU - Kakuta, Yoichi
AU - Kinouchi, Yoshitaka
AU - Masamune, Atsushi
N1 - Publisher Copyright:
© 2024 Korean Society of Gastrointestinal Endoscopy.
PY - 2024/9
Y1 - 2024/9
N2 - Background/Aims: During endoscopy, white spots (WS) are sometimes observed around benign or malignant colorectal tumors; however, few reports have investigated WS, and their significance remains unknown. Therefore, we investigated the significance of WS from clinical and pathological viewpoints and evaluated its usefulness in endoscopic diagnosis. Methods: Clinical data of patients with lesions diagnosed as epithelial tumors from January 1, 2019, to December 31, 2020, were analyzed (n=3,869). We also performed a clinicopathological analysis of adenomas or carcinomas treated with endoscopic resection (n=759). Subsequently, detailed pathological observations of the WS were performed. Results: The positivity rates for WS were 9.3% (3,869 lesions including advanced cancer and non-adenoma/carcinoma) and 25% (759 lesions limited to adenoma and early carcinoma). Analysis of 759 lesions showed that the WS-positive lesion group had a higher proportion of cancer cases and larger tumor diameters than the WS-negative group. Multiple logistic analysis revealed the following three statistically significant risk factors for carcinogenesis: positive WS, flat lesions, and tumor diameter ≥5 mm. Pathological analysis revealed that WS were macrophages that phagocytosed fat and mucus and were white primarily because of fat. Conclusions: WS are cancer-related findings and can become a new criterion for endoscopic resection in the future.
AB - Background/Aims: During endoscopy, white spots (WS) are sometimes observed around benign or malignant colorectal tumors; however, few reports have investigated WS, and their significance remains unknown. Therefore, we investigated the significance of WS from clinical and pathological viewpoints and evaluated its usefulness in endoscopic diagnosis. Methods: Clinical data of patients with lesions diagnosed as epithelial tumors from January 1, 2019, to December 31, 2020, were analyzed (n=3,869). We also performed a clinicopathological analysis of adenomas or carcinomas treated with endoscopic resection (n=759). Subsequently, detailed pathological observations of the WS were performed. Results: The positivity rates for WS were 9.3% (3,869 lesions including advanced cancer and non-adenoma/carcinoma) and 25% (759 lesions limited to adenoma and early carcinoma). Analysis of 759 lesions showed that the WS-positive lesion group had a higher proportion of cancer cases and larger tumor diameters than the WS-negative group. Multiple logistic analysis revealed the following three statistically significant risk factors for carcinogenesis: positive WS, flat lesions, and tumor diameter ≥5 mm. Pathological analysis revealed that WS were macrophages that phagocytosed fat and mucus and were white primarily because of fat. Conclusions: WS are cancer-related findings and can become a new criterion for endoscopic resection in the future.
KW - Adenoma
KW - Colorectal neoplasms
KW - Colorectal tumors
KW - Endoscopic diagnosis
KW - White spots
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U2 - 10.5946/ce.2024.027
DO - 10.5946/ce.2024.027
M3 - Article
AN - SCOPUS:85205800017
SN - 2234-2400
VL - 57
SP - 637
EP - 646
JO - Clinical Endoscopy
JF - Clinical Endoscopy
IS - 5
ER -