Hirano Akikazu, Yao Kenshi, Ishihara Hiroshi, Hisabe Takashi, Imamura Kentaro, Kanemitsu Takao, Ohtsu Kensei, Hasegawa Rino, Ikezono Go, Takeda Kazuhiro, Miyaoka Masaki, Ueki Toshiharu, Tanabe Hiroshi, Haraoka Seiji, Iwashita Akinori
Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Endosc Int Open. 2021 Jul;9(7):E1077-E1083. doi: 10.1055/a-1452-9669. Epub 2021 Jun 17.
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. 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. 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 ( < 0.001). The density of the WOS was strongly and positively correlated with the area of adipophilin-positive cells. 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.
使用放大内镜（ME）观察到，在胃、十二指肠和结肠上皮腺瘤及癌的上皮组织中存在一种白色不透明物质（WOS）。据报道，WOS源自上皮组织中微小脂滴的密集堆积。本研究旨在探讨结肠增生性息肉中的WOS是否如在胃、十二指肠和结肠上皮肿瘤中观察到的那样，源自上皮组织中积累的脂滴。我们分析了30例经窄带成像ME显示结肠增生性息肉中WOS呈阳性的连续患者，以及30例WOS呈阴性的连续患者。从息肉获取的活检标本用抗脂肪分化相关蛋白抗体进行免疫染色，以确定WOS的存在与上皮组织中脂滴的存在之间的相关性。在所有患者中，上皮细胞在组织学上对脂肪分化相关蛋白呈阳性。然而，WOS阳性组中脂肪分化相关蛋白阳性上皮细胞的面积显著大于WOS阴性组（<0.001）。WOS的密度与脂肪分化相关蛋白阳性细胞的面积呈强正相关。本研究表明，在结肠增生性息肉表层观察到的WOS是由息肉上皮组织中微小脂滴的密集堆积产生的。
