Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 750-760
Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.750
Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps
Ying-Jie Zhang, Meng-Xia Yuan, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Ye Yang, Feng-Lin Chen
Ying-Jie Zhang, Meng-Xia Yuan, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Department of Digestive Diseases, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
Ye Yang, Feng-Lin Chen, Graduate School, Chengdu Medical College, Chengdu 610000, Sichuan Province, China
Author contributions: All authors contributed to the study conception and design; material preparation, Zhang YJ, Wen W, Li F, and Yuan MX performed data curation, and formal analysis; Zhang YJ, Jian Y, Zhang CM, and Yuan MX performed project administration and supervision; Zhang YJ wrote the original draft; Yuan MX, Yang Y, and Chen FL contributed to review and editing; All authors commented on subsequent versions of the manuscript, and all authors read and approved the final manuscript.
Supported by the Science and Technology Plan Project of Chengdu Municipal Health Commission, No. 2019007.
Institutional review board statement: This study was approved by the Ethics Committee of Chengdu Second People's Hospital, No. 2021018.
Informed consent statement: The requirement for informed consent was waived because our study does not invade personal privacy and has little risk to patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
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.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Meng-Xia Yuan, MD, Doctor, Department of Digestive Diseases, Chengdu Second People’s Hospital, No. 10 Qingyun South Street, Chengdu 610000, Sichuan Province, China. 1062274198@qq.com
Received: October 26, 2023
Peer-review started: October 26, 2023
First decision: December 5, 2023
Revised: January 2, 2024
Accepted: February 6, 2024
Article in press: February 6, 2024
Published online: March 15, 2024
Processing time: 137 Days and 21.3 Hours
ARTICLE HIGHLIGHTS
Research background

Lipid metabolism reprogramming is suspected to exist in pre-cancerous lesions, including colorectal adenoma. Chicken skin mucosa (CSM) surrounding colorectal polyps is frequently detected during screening colonoscopy. CSM is the pathological accumulation of fat in the macrophages of the lamina propria.

Research motivation

CSM-positive colorectal polyps are associated with various diseases; however, their clinical significance is not yet clear, and they are often not properly treated. We conducted this study to highlight the clinical significance of CSM surrounding colorectal polyps and to clarify the associated treatment for endoscopists.

Research objectives

We performed risk stratification analysis of CSM-positive colorectal polyps under white light endoscopy to identify possible risk factors for malignant transformation and submucosal infiltration of CSM-positive colorectal polyps.

Research methods

This study retrospectively recorded the endoscopic appearance, clinical features, and pathological findings of patients with CSM-positive colorectal polyps. The Student’s t-test, χ2 test, and logistic regression were used to analyze and compare the clinical features, suspected risk factors for malignant transformation of neoplastic polyps, and early infiltration of submucosal carcinoma.

Research results

We found that a diameter of > 1 cm or a deeper red mucosa may be independent risk factors for the malignant transformation of CSM-positive colorectal neoplastic polyps. Partial or complete resection of the CSM around colorectal adenomas did not affect tumor recurrence, and the CSM disappeared within 12 months after polypectomy.

Research conclusions

CSM has emerged as a critical feature of early colorectal cancer or pre-cancerous lesions. We found that a diameter of > 1 cm or a deeper red mucosa may be independent risk factors for the malignant transformation of CSM-positive colorectal neoplastic polyps. Endoscopic mucosal resection may be the best treatment option for these lesions. Partial or complete resection of the CSM around colorectal adenomas did not affect tumor recurrence. Abnormal CSM should not be considered when resecting CSM-positive colorectal adenomas endoscopically.

Research perspectives

We should pay more attention to the endoscopic features of different types of lipid metabolic abnormalities and attempt to discover the relationship between these characteristics and pathological changes.