Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps  

作　　者：Ying-Jie Zhang Meng-Xia Yuan Wu Wen Fan Li Yi Jian Chuan-Ming Zhang Ye Yang Feng-Lin Chen 

机构地区：[1]Department of Digestive Diseases,Chengdu Second People’s Hospital,Chengdu 610000,Sichuan Province,China [2]Graduate School,Chengdu Medical College,Chengdu 610000,Sichuan Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第3期750-760,共11页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：the Science and Technology Plan Project of Chengdu Municipal Health Commission,No.2019007.

摘　　要：BACKGROUND Lipid metabolism reprogramming is suspected to exist in pre-cancerous lesions,including colorectal adenoma.Screening colonoscopy frequently reveals chicken skin mucosa(CSM;white or yellow-white speckled mucosa)surrounding colo-rectal polyps,caused by macrophages engulfing and accumulating the lipids decomposed by colon cells or adjacent tumors.CSM-positive colorectal polyps are associated with various diseases;however,their prognosis varies greatly.Cold snare polypectomy is commonly used to resect lesions up to 10 to 15 mm in diameter without signs of submucosal invasion but is controversial for CSM-positive colorectal polyps.Improved imaging is required to diagnose and treat CSM-positive colorectal polyps.METHODS This retrospective cohort study included 177 patients with CSM-positive colorectal polyps diagnosed using endoscopy.All patient-related information was extracted from the Goldisc soft-clinic DICOM system or electronic medical record system.Based on the pathological results,patients were classified as non-neoplastic polyps(five juvenile polyps),neoplastic polyps,non-invasive high-grade neoplasia(NHGN),or submucosal invasive carcinoma(SM stage cancer).We analyzed and compared the clinical features,suspected risk factors for malignant transformation of neoplastic polyps,and early infiltration of sub-mucosal carcinoma.RESULTS The diameters of NHGN and SM polyps were much smaller than those of neoplastic polyps.Most NHGN polyps had a deeper red mucosal color.On logistic regression analyses,diameter and deeper red mucosal color were independent risk factors for malignant transformation of neoplastic polyps.Type 1 CSM was more common in high-grade intraepithelial neoplasia and SM;type 2 CSM was more common in neoplastic polyps.Logistic regression analyses revealed no significant differences in the malignant transformation of neoplastic polyps or early submucosal invasion of CSM-positive colorectal cancer.Changes in the CSM mucosa surrounding neoplastic polyps and submucosal invasion of colorectal ca

关 键 词：Chicken skin mucosa Colorectal cancer Colorectal polyps Endoscopic resection Malignant transformation White light endoscopy 

分 类 号：R735.32[医药卫生—肿瘤]