White spots around colorectal tumors are cancer-related findings and may aid endoscopic diagnosis: a prospective study in Japan
- Author:
Kai KOREKAWA
1
;
Yusuke SHIMOYAMA
;
Fumiyoshi FUJISHIMA
;
Hiroshi NAGAI
;
Takeo NAITO
;
Rintaro MOROI
;
Hisashi SHIGA
;
Yoichi KAKUTA
;
Yoshitaka KINOUCHI
;
Atsushi MASAMUNE
Author Information
- Publication Type:Original Article
- From:Clinical Endoscopy 2024;57(5):637-646
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
