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World J Gastroenterol. Jul 21, 2013; 19(27): 4300-4308
Published online Jul 21, 2013. doi: 10.3748/wjg.v19.i27.4300
Published online Jul 21, 2013. doi: 10.3748/wjg.v19.i27.4300
Pink-color sign in esophageal squamous neoplasia, and speculation regarding the underlying mechanism
Ryu Ishihara, Hiroyasu Iishi, Kengo Nagai, Fumi Matsui, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Sachiko Yamamoto, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Masaharu Tatsuta, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan
Hiromitsu Kanzaki, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Okayama 700-0082, Japan
Yasuhiko Tomita, Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan
Shingo Ishiguro, PCL Osaka Inc., Osaka 537-8511, Japan
Author contributions: Ishihara R, Kanzaki H, Ishiguro S, Nagai K, Matsui F, Yamashina T, Matsuura N, Ito T, Fujii M, Yamamoto S, Hanaoka N, Takeuchi Y, Higashino K, Uedo N, Iishi H, Tatsuta M and Tomita Y contributed to Conception and design, and final approval of the article; Ishihara R, Kanzaki H and Ishiguro S contributed to data analysis and interpretation; Ishihara R contributed to drafting of the article.
Correspondence to: Ryu Ishihara, MD, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 3-3, Nakamichi 1-chome, Higashinari-ku, Osaka 537-8511, Japan. isihara-ry@mc.pref.osaka.jp
Telephone: +81-6-69721181 Fax: +81-6-69814067
Received: March 7, 2013
Revised: May 16, 2013
Accepted: May 18, 2013
Published online: July 21, 2013
Revised: May 16, 2013
Accepted: May 18, 2013
Published online: July 21, 2013
Core Tip
Core tip: The pink-color sign of iodine-unstained lesions is useful for the diagnosis of esophageal squamous cell carcinoma. We investigated histologic findings of esophageal neoplasms, and found that absence of the keratinous layer because of neoplastic cell proliferation may be responsible for the pink-color sign. Quantitative analysis of color showed that pink-color sign positive mucosa underwent early color fading from the color of the iodine (yellow) to the color of the mucosa (pink) within 2-3 min. Based on these results, we speculated on the mechanism underlying the pink-color sign. These findings may improve our understanding of the characteristics of esophageal neoplasms.