Hara Yuko, Goda Kenichi, Hirooka Shinichi, Mitsuishi Takehiro, Ikegami Masahiro, Sumiyama Kazuki
Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
Gastrointestinal Endoscopy Center, Dokkyo Medical University, Tochigi 321-0293, Japan.
Diagnostics (Basel). 2021 Apr 25;11(5):769. doi: 10.3390/diagnostics11050769.
We previously reported that superficial non-ampullary duodenal tumors (SNADETs) commonly had a whitish mucosal surface, named milk-white mucosa (MWM). The aim of this study was to evaluate the association of MWM with epithelial intracellular lipid droplets (immunohistochemically stained by adipose differentiation-related protein (ADRP)) and histological tumor grades. We reviewed endoscopic images and the histopathology of SNADETs resected en bloc endoscopically. We analyzed the correlation between the positive rates of endoscopic MWM in preoperative endoscopy and resected specimens, and ADRP-positive rates in the resected specimens. Associations between the MWM-positive rates and tumor grades, high-grade intraepithelial neoplasia (HGIN)/intramucosal carcinoma (IC), and low-grade intraepithelial neoplasia (LGIN) were analyzed. All the 92 SNADETs analyzed were <20 mm and histologically classified into 39 HGIN/IC and 53 LGIN. Spearman's rank correlation coefficient showed a significant correlation between MWM-positive and ADRP-positive rates ( < 0.001). MWM-positive rates were significantly lower in the HGIN/IC than in the LGIN in preoperative endoscopy ( < 0.001) and resected specimens ( = 0.02). Our results suggest that endoscopic MWM is closely associated with epithelial intracellular lipid droplets and that the MWM-positive rate may be a predictor of histological grade in small SNADETs.
我们之前报道过，浅表非壶腹十二指肠肿瘤（SNADETs）通常有白色黏膜表面，称为乳白黏膜（MWM）。本研究的目的是评估MWM与上皮细胞内脂质滴（通过脂肪分化相关蛋白（ADRP）免疫组化染色）及组织学肿瘤分级之间的关联。我们回顾了经内镜整块切除的SNADETs的内镜图像和组织病理学。我们分析了术前内镜检查和切除标本中内镜下MWM阳性率与切除标本中ADRP阳性率之间的相关性。分析了MWM阳性率与肿瘤分级、高级别上皮内瘤变（HGIN）/黏膜内癌（IC）和低级别上皮内瘤变（LGIN）之间的关联。分析的所有92例SNADETs均<20 mm，组织学上分为39例HGIN/IC和53例LGIN。Spearman等级相关系数显示MWM阳性率与ADRP阳性率之间存在显著相关性（<0.001）。术前内镜检查（<0.001）和切除标本（=0.02）中，HGIN/IC的MWM阳性率显著低于LGIN。我们的结果表明，内镜下MWM与上皮细胞内脂质滴密切相关，MWM阳性率可能是小SNADETs组织学分级的一个预测指标。
