Chicken skin mucosa is independently associated with advanced colorectal adenoma with transmembrane member 16A potentially involved in this association

doi:10.3748/wjg.118486

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Sep 7, 2026; 32(33): 118486
Published online Sep 7, 2026. doi: 10.3748/wjg.118486

Chicken skin mucosa is independently associated with advanced colorectal adenoma with transmembrane member 16A potentially involved in this association

Rui-Jie Wang, Yang Hu, Shi-Bin Guo

Rui-Jie Wang, Yang Hu, Shi-Bin Guo, Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian 116001, Liaoning Province, China

Rui-Jie Wang, Department of Gastroenterology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China

Co-first authors: Rui-Jie Wang and Yang Hu.

Author contributions: Wang RJ and Hu Y collected and analyzed the data, they contributed equally to this article, they are the co-first authors of this manuscript; Wang RJ, Hu Y, and Guo SB wrote this manuscript; Guo SB designed this study and edited the manuscript; and all authors have read and approved the manuscript.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Dalian Medical University, approval No. PJ-KS-KY-2022-327.

Informed consent statement: Written informed consent was obtained from patients or their relatives.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Corresponding author: Shi-Bin Guo, Professor, Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian 116001, Liaoning Province, China. guoshibin@firsthosp-dmu.com

Received: January 9, 2026
Revised: April 1, 2026
Accepted: May 6, 2026
Published online: September 7, 2026
Processing time: 212 Days and 12.6 Hours

Abstract

BACKGROUND

Chicken skin mucosa (CSM) is an endoscopic finding characterized by a speckled, pale-yellow appearance on the colorectal surface, which results from lipid accumulation in the lamina propria. The clinical role of CSM remains unclear.

AIM

To investigate the clinical significance of CSM by evaluating the clinical, endoscopic, pathological, and immunohistochemical transmembrane member 16A (TMEM16A, a calcium-activated chloride channel) characteristics of adenomas.

METHODS

This retrospective study included 2237 consecutive patients who were pathologically diagnosed with colorectal adenomas and underwent endoscopic polypectomy at the First Affiliated Hospital of Dalian Medical University between September 2021 and January 2023. Clinical, colonoscopic, and pathological data from colorectal adenomas were collected and analyzed. TMEM16A protein expression was detected by immunohistochemical analysis in 37 consecutive adenomas with CSM and 38 consecutive adenomas without CSM.

RESULTS

The mean age of patients in the CSM group was higher than that in the non-CSM group (P = 0.02). The CSM group had a greater incidence of multiple adenomas (P < 0.001) and larger median adenoma size (P < 0.001). Adenomas with CSM were predominantly located in the distal colon and exhibited protruding morphology. There was a significant difference in the distribution and morphology of the adenomas between the two groups (P < 0.001). The incidence of advanced adenomas in the CSM group was greater than that in the non-CSM group (P < 0.001), and the presence of CSM was independently associated with advanced adenomas (adjusted odds ratio: 81.670; 95% confidence interval: 29.902-223.062; P < 0.001). TMEM16A expression was higher in the CSM group than in the non-CSM group (P = 0.034), and it was significantly elevated in the advanced adenomas group compared to non-advanced adenomas (P < 0.001).

CONCLUSION

This study demonstrates an independent association between the presence of CSM and advanced colorectal adenoma, potentially mediated by TMEM16A. These findings offer valuable insights for enhancing decision-making and patient management strategies.

Keywords: Chicken skin mucosa; Adenoma; Advanced adenoma; Transmembrane member 16A

Core Tip: Chicken skin mucosa (CSM) is an endoscopic, pale-yellow, speckled pattern appearing on colorectal mucosa, typically adjacent to colorectal neoplasm. Our study demonstrated that CSM is independently associated with advanced colorectal adenomas, featuring characteristics such as large size, multiple occurrences, distal location, protruding morphology, and dysplastic histology. Transmembrane member 16A (a calcium-activated chloride channel) expression was significantly higher in advanced than non-advanced adenomas based on immunohistochemistry. The independent link between CSM and advanced colorectal adenoma offers valuable insights for improved clinical decision-making and patient management.