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Akazawa Y, Ueyama H, Tsuyama S, Ikeda A, Yatagai N, Komori H, Takeda T, Matsumoto K, Matsumoto K, Hashimoto T, Tomita N, Kajiyama Y, Kato M, Yao T, Nagahara A. Endoscopic and Clinicopathological Features of Superficial Non-Ampullary Duodenal Tumor Based on the Mucin Phenotypes. Digestion 2021; 102:663-670. [PMID: 32516774 PMCID: PMC8491506 DOI: 10.1159/000508040] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/07/2020] [Indexed: 02/04/2023]
Abstract
AIMS We aimed to clarify the endoscopic/clinicopathological features of superficial non-ampullary duodenal epithelial tumors (SNADETs) based on their mucin phenotypes. METHODS We analyzed 62 SNADET lesions and classified them based on mucin phenotypic expression. Endoscopic and clinicopathological findings were compared according to mucin phenotypes. RESULTS Eleven lesions had the gastric phenotype (GP) and 43 lesions had the intestinal phenotype (IP). All GP lesions were located in the first portion of the duodenum, while most IP lesions (72.1%) were located in the second portion (p < 0.01). Tumor size was significantly larger in the GP than in the IP group (14.4 mm vs. 10.2 mm, p < 0.05). Reddish color (72.7% in GP vs. 37.2% in IP, p < 0.05), type 0-I (72.7% vs. 11.6%, p < 0.01), lobular/granular pattern (81.8% vs. 4.7%, p < 0.01), and category 4/5 in Vienna classification (81.8% vs. 30.2%, p < 0.01) were observed significantly more often in the GP than in the IP group. Regarding findings of magnifying endoscopy with narrow-band imaging (M-NBI), white opaque substance (22.2% in GP vs. 89.7% in IP, p < 0.01) and light blue crest (0% vs. 43.6%, p < 0.05) were significantly less frequently observed in the GP group. Oval-shaped marginal epithelium (66.7% vs. 17.9%, p < 0.01), dense pattern (55.6% vs. 2.6%, p < 0.01), and dilatation of the intervening part (100% vs. 12.8%, p < 0.01) were more frequently observed in the GP group. CONCLUSIONS SNADETs showed distinct endoscopic/clinicopathological features according to the mucin phenotype. Tumor location, coloration, macroscopic type, and endoscopic findings including M-NBI are useful to distinguish the mucin phenotypes of SNADETs.
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Affiliation(s)
- Yoichi Akazawa
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroya Ueyama
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan,*Dr. Hiroya Ueyama, Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan),
| | - Sho Tsuyama
- Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
| | - Atsushi Ikeda
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Noboru Yatagai
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Komori
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tsutomu Takeda
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kohei Matsumoto
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenshi Matsumoto
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takashi Hashimoto
- Department of Esophageal and Gastroenterological Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Natsumi Tomita
- Department of Esophageal and Gastroenterological Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshiaki Kajiyama
- Department of Esophageal and Gastroenterological Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Motohiko Kato
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Yao
- Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akihito Nagahara
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
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Lipid droplets: platforms with multiple functions in cancer hallmarks. Cell Death Dis 2020; 11:105. [PMID: 32029741 PMCID: PMC7005265 DOI: 10.1038/s41419-020-2297-3] [Citation(s) in RCA: 221] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 02/06/2023]
Abstract
Lipid droplets (also known as lipid bodies) are lipid-rich, cytoplasmic organelles that play important roles in cell signaling, lipid metabolism, membrane trafficking, and the production of inflammatory mediators. Lipid droplet biogenesis is a regulated process, and accumulation of these organelles within leukocytes, epithelial cells, hepatocytes, and other nonadipocyte cells is a frequently observed phenotype in several physiologic or pathogenic situations and is thoroughly described during inflammatory conditions. Moreover, in recent years, several studies have described an increase in intracellular lipid accumulation in different neoplastic processes, although it is not clear whether lipid droplet accumulation is directly involved in the establishment of these different types of malignancies. This review discusses current evidence related to the biogenesis, composition and functions of lipid droplets related to the hallmarks of cancer: inflammation, cell metabolism, increased proliferation, escape from cell death, and hypoxia. Moreover, the potential of lipid droplets as markers of disease and targets for novel anti-inflammatory and antineoplastic therapies will be discussed.
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Yang G, Du W, Zhang X, Huang T, Zhang J, Liu J, Ling Y. The white substance may be a potential endoscopic marker for flat esophageal mucosal neoplastic lesions: A new endoscopic observation. Medicine (Baltimore) 2018; 97:e11885. [PMID: 30170379 PMCID: PMC6392511 DOI: 10.1097/md.0000000000011885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine whether the white substance can act as an endoscopic marker for flat esophageal mucosal neoplastic lesions.Esophageal mucosal neoplastic lesions are mainly identified using white light endoscopy, because it is cost-effective; however, this method is limited for detecting early esophageal cancer and precancerous lesions, because these are typically flat mucosal neoplastic lesions. In our experience, a white substance surrounds or covers some flat esophageal mucosal lesions that are eventually diagnosed as neoplastic lesions by biopsy pathology.After retrospective analysis of pathological and clinical data of 20,390 patients, we identified 352 patients with flat esophageal mucosal lesions on endoscopic images. Images were re-evaluated by 2 experienced endoscopists and the prevalence of the white substance recorded. Patients were divided into non-neoplastic and neoplastic groups, based on pathology.The white substance was present in 3.5% (5/144) of non-neoplastic and 14.9% (31/208) of neoplastic cases (P < .05). The diagnostic sensitivity and specificity of the white substance for neoplastic lesions diagnosis were 14.9% and 96.5%, respectively. The presence of white substance was more common in males and in those aged 50 to 79 years. It was more commonly observed in the middle third of the esophagus, and its presence did not correlate with sex, age, or lesion location (P > .05).The white substance, which is easily detected by white light endoscopy, may be an endoscopic marker facilitating detection of flat esophageal mucosal neoplastic lesions, irrespective of sex, age, and lesion location.
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Kawasaki K, Eizuka M, Nakamura S, Endo M, Yanai S, Akasaka R, Toya Y, Fujita Y, Uesugi N, Ishida K, Sugai T, Matsumoto T. Association between white opaque substance under magnifying colonoscopy and lipid droplets in colorectal epithelial neoplasms. World J Gastroenterol 2017; 23:8367-8375. [PMID: 29307996 PMCID: PMC5743507 DOI: 10.3748/wjg.v23.i47.8367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To examine the association between white opaque substance (WOS) and histologically verified lipid droplets in colorectal epithelial neoplasms.
METHODS We reviewed colonoscopy records at our institution from 2014 to 2016 and identified cases of endoscopically or surgically resected colorectal epithelial neoplasms observed by magnifying narrow-band imaging (M-NBI) colonoscopy. Immunohistochemistry was used to stain tumors with a monoclonal antibody specific to adipophilin as a marker of lipids. The expression and distribution of adipophilin were compared between WOS-positive and WOS-negative lesions and among tumors classified by histologic type and depth of invasion.
RESULTS Under M-NBI colonoscopy, 81 lesions were positive for WOS and 48 lesions were negative for WOS. The rate of adipophilin expression was significantly higher in WOS-positive lesions (95.1%) than in WOS-negative lesions (68.7%) (P = 0.0001). The incidence of deep adipophilin expression was higher in WOS-positive lesions (24.7%) than in WOS-negative lesions (4.2%) (P = 0.001). The incidence of deep expression was predominant among cancers with massive submucosal invasion (62.5%) compared to adenoma (7.2%) and high-grade dysplasia or cancers with slight submucosal invasion (12.7%) (P = 0.0001).
CONCLUSION The distribution of lipid droplets may be closely associated with the visibility of WOS under M-NBI colonoscopy, and with histologic grade and depth of tumor invasion.
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Affiliation(s)
- Keisuke Kawasaki
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan
| | - Makoto Eizuka
- Department of Diagnostic Pathology, Iwate Medical University, Morioka 020-8505, Japan
| | - Shotaro Nakamura
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan
| | - Masaki Endo
- Kaiunbashi Endoscopy Clinic, Morioka 020-0022, Japan
| | - Shunichi Yanai
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan
| | - Risaburo Akasaka
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan
| | - Yosuke Toya
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan
| | - Yasuko Fujita
- Department of Diagnostic Pathology, Iwate Medical University, Morioka 020-8505, Japan
| | - Noriyuki Uesugi
- Department of Diagnostic Pathology, Iwate Medical University, Morioka 020-8505, Japan
| | - Kazuyuki Ishida
- Department of Diagnostic Pathology, Iwate Medical University, Morioka 020-8505, Japan
| | - Tamotsu Sugai
- Department of Diagnostic Pathology, Iwate Medical University, Morioka 020-8505, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan
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Takada N, Hirokawa M, Ito A, Suzuki A, Higuchi M, Kuma S, Hayashi T, Daa T, Miyauchi A. Cytoplasmic Lipid Accumulation Characteristic of the Cribriform Variant of Papillary Thyroid Carcinoma. Pathobiology 2017; 84:251-257. [PMID: 28810260 DOI: 10.1159/000477910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/30/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The purpose of this study was to clarify the diagnostic significance of cytoplasmic lipid accumulation (CLIA) in the cribriform variant of papillary thyroid carcinoma (CV-PTC). METHODS We performed a histological, immunohistochemical, and cytological examination of 35 CV-PTC cases at the Kuma Hospital. CLIA was defined as bubble-like multivacuolation in cytoplasm with distinct cell border. We also examined 100 conventional PTC (con-PTC) cases as controls. RESULTS Histological analysis showed the presence of carcinoma cells with CLIA in 60.0% of CV-PTC and 5.0% of con-PTC cases. The vacuoles tended to distribute in the subnuclear portion of carcinoma cells showing papillary growth. They were positive for oil red O staining and adipophilin. The carcinoma cells without the vacuoles showed a subnuclear dot-like expression for adipophilin in CV-PTC cases, but not in the con-PTC cases. Cytological analysis showed CLIA in 17 (54.8%) of the 31 CV-PTC cases, but not in the con-PTC cases. CONCLUSION This is the first study to report the presence of carcinoma cells with CLIA in CV-PTC. The subnuclear dot-like expression of adipophilin may be characteristic of CV-PTC. These findings might be related to degenerative changes occurring in CV-PTC.
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Affiliation(s)
- Nami Takada
- Department of Clinical Laboratory, Kuma Hospital, Kobe, Japan
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Lanke G, Agarwal A, H. Lee J. How to manage gastric polyps. INTERNATIONAL JOURNAL OF GASTROINTESTINAL INTERVENTION 2016. [DOI: 10.18528/gii150035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Gandhi Lanke
- Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Atin Agarwal
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey H. Lee
- Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Ueo T, Yonemasu H, Yao K, Ishida T, Togo K, Yanai Y, Fukuda M, Motomura M, Narita R, Murakami K. Histologic differentiation and mucin phenotype in white opaque substance-positive gastric neoplasias. Endosc Int Open 2015; 3:E597-604. [PMID: 26716119 PMCID: PMC4683146 DOI: 10.1055/s-0034-1393177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND STUDY AIMS The authors previously reported that the white opaque substance (WOS) in gastric epithelial neoplasia was caused by accumulation of lipid droplets by immunohistochemical and immunoelectron microscopic studies of adipophilin, which was recently identified and validated as a marker of lipid droplets. The aim of the current study was to investigate the characteristics of the histologic differentiation and mucin phenotype in WOS-positive gastric epithelial neoplasias. PATIENTS AND METHODS A total of 130 gastric epithelial neoplasias (45 adenomas and 85 early adenocarcinomas) from 120 patients were retrospectively evaluated. The presence or absence of WOS was evaluated by M-NBI. Lipids were examined by immunohistochemical staining for adipophilin. Tissue phenotypes were immunohistochemically classified as intestinal (I), gastrointestinal (GI), and gastric (G) using antibodies against CD10, MUC2, MUC5AC and MUC6. The histologic differentiation and mucin phenotype of WOS-positive neoplasias were characterized and examined according to adipophilin expression. RESULTS The presence of WOS by M-NBI was correlated with histologic differences between adenoma or differentiated type adenocarcinoma and mixed type or undifferentiated type adenocarcinoma (P = 0.0153). Adipophilin was only expressed in primary adenoma and well to moderately differentiated adenocarcinoma components but not in undifferentiated components. WOS and adipophilin expression were only observed in neoplasias with I or GI phenotypes, but not in those with the G phenotype (P < 0.0001). CONCLUSIONS WOS in gastric epithelial neoplasias might indicate differentiation into a mature histological subtype with GI or I mucin phenotype.
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Affiliation(s)
- Tetsuya Ueo
- Department of Gastroenterology, Oita Red Cross Hospital, Japan
| | | | - Kenshi Yao
- Department of Endoscopy, Fukuoka University Chikushi Hospital, Japan
| | - Tetsuya Ishida
- Department of Gastroenterology, Oita Red Cross Hospital, Japan
| | - Kazumi Togo
- Department of Gastroenterology, Oita Red Cross Hospital, Japan
| | - Yuka Yanai
- Department of Gastroenterology, Oita Red Cross Hospital, Japan
| | - Masahide Fukuda
- Department of Gastroenterology, Oita Red Cross Hospital, Japan
| | | | - Ryoich Narita
- Department of Gastroenterology, Oita Red Cross Hospital, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Japan
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Yao K. Clinical Application of Magnifying Endoscopy with Narrow-Band Imaging in the Stomach. Clin Endosc 2015; 48:481-90. [PMID: 26668793 PMCID: PMC4676664 DOI: 10.5946/ce.2015.48.6.481] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/11/2015] [Accepted: 11/13/2015] [Indexed: 12/17/2022] Open
Abstract
Magnifying endoscopy with narrow-band imaging (M-NBI) can visualize superficial microanatomies in the stomach. The normal morphology of the microanatomy visualized by M-NBI differs according to the part of the stomach. The gastric fundic glandular mucosa appears as a regular honeycomb-like subepithelial capillary network (SECN) pattern with a regular collecting venule pattern and regular oval crypt opening with circular marginal crypt epithelium (MCE) pattern. The gastric pyloric glandular mucosa displays a regular coil-shaped SECN pattern and regular polygonal or curved MCE pattern. For a diagnosis of early gastric cancer using M-NBI, the vessel plus surface classification system was developed. This system is clinically useful for the differential diagnosis of focal gastritis and small depressed cancer and for determining the horizontal extent of early gastric cancer for successful endoscopic resection. Advantages of M-NBI over conventional endoscopic imaging techniques with white light include accurate diagnosis and cost effectiveness. This technique is a breakthrough in the endoscopic diagnostic field.
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Affiliation(s)
- Kenshi Yao
- Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan
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Yoshii S, Kato M, Honma K, Fujinaga T, Tsujii Y, Maekawa A, Inoue T, Hayashi Y, Akasaka T, Shinzaki S, Nishida T, Iijima H, Tsujii M, Morii E, Takehara T. Esophageal adenocarcinoma with white opaque substance observed by magnifying endoscopy with narrow band imaging. Dig Endosc 2015; 27:392-6. [PMID: 25041337 DOI: 10.1111/den.12331] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 07/04/2014] [Indexed: 12/12/2022]
Abstract
White opaque substance (WOS) is observed in the gastric neoplasia of 0-IIa type using magnifying endoscopy with narrow band imaging (NBI-ME). Colonic and duodenal neoplasms with WOS have also been reported. Immunohistochemical examination with adipophilin reveals WOS in gastric neoplasms as lipid droplets, and WOS is specific for neoplasm with intestinal or gastrointestinal phenotype. We herein report a case of adenocarcinoma of the esophagogastric junction with WOS. A male patient in his sixties was found by esophagogastroduodenoscopy to have an esophageal elevated lesion. NBI-ME showed whitish deposits that looked similar to WOS in gastric neoplasms. The patient underwent endoscopic submucosal dissection and the lesion was resected in a single piece. This tumor had diffuse positivity for adipophilin and gastrointestinal phenotype.
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Affiliation(s)
- Shunsuke Yoshii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
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