Endoscopic features of lymphoid follicles using blue laser imaging (BLI) endoscopy in the colorectum and its association with chronic bowel symptoms

Tomomitsu Tahara, Kazuya Takahama, Sayumi Tahara, Dai Yoshida, Noriyuki Horiguchi, Tomohiko Kawamura, Masaaki Okubo, Mitsuo Nagasaka, Yoshihito Nakagawa, Makoto Urano, Tomoyuki Shibata, Tetsuya Tuskamoto, Hiro o. Ieda, Makoto Kuroda, Naoki Omiya

Research output: Contribution to journalArticle

Abstract

Background/Aim: In the colorectum, lymphoid follicles hyperplasia (LH) is sometimes observed as small, round, yellowish-white nodules. The novel image-enhanced endoscopy system named blue laser imaging (BLI) provides enhanced the contrast of surface vessels using lasers for light illumination. We investigated the endoscopic features of LH observed by using BLI endoscopy and its association with chronic bowel symptoms. Patients/Methods: 300 participants undergoing colonoscopy for various indications were enrolled. Entire colorectum was observed by using BLI-bright mode with non-magnification view. LH was defined as well demarcated white nodules. Elevated LH with erythema was distinguished as LH severe. Results: LHs were observed more clearly by using BLI-bright mode compared to conventional white light colonoscopy and were also histologically confirmed as intense infiltration of lymphocytes or plasmacytes. LH was observed in 134 subjects (44.6%) and 67 (22.3%) were LH severe. LH was associated younger age (Odds ratio (OR) = 1.05, 95%Confidence Interval (95%CI) = 1.03–1.07, P<0.0001) and chronic bowel symptoms including constipation, hard stools, diarrhea and loose stools (all LH: OR = 4.03, 95%CI = 2.36–6.89, P<0.0001, LH severe: OR = 5.31, 95%CI = 2.64–10.71, P<0.0001). LH severe was closely associated with both constipation associated symptoms (OR = 3.94, 95%CI = 1.79–8.66, P = 0.0007) and diarrhea associated symptoms (OR = 5.22, 95%CI = 2.09–13.05, P = 0.0004). In particular, LH severe in the ascending colon was strongly associated with bowel symptoms (P<0.0001). Conclusion: LH, visualized by using BLI endoscopy was associated with bowel symptom, raising the possibility of pathogenic role of this endoscopic finding in the functional lower gastrointestinal disorders.

Original languageEnglish
Article numbere0182224
JournalPLoS One
Volume12
Issue number8
DOIs
Publication statusPublished - 01-08-2017

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Endoscopy
endoscopy
signs and symptoms (animals and humans)
lasers
Lasers
odds ratio
image analysis
confidence interval
Imaging techniques
Odds Ratio
Confidence Intervals
colonoscopy
constipation
Constipation
Colonoscopy
Laser modes
Diarrhea
diarrhea
Light
Ascending Colon

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Tahara, Tomomitsu ; Takahama, Kazuya ; Tahara, Sayumi ; Yoshida, Dai ; Horiguchi, Noriyuki ; Kawamura, Tomohiko ; Okubo, Masaaki ; Nagasaka, Mitsuo ; Nakagawa, Yoshihito ; Urano, Makoto ; Shibata, Tomoyuki ; Tuskamoto, Tetsuya ; Ieda, Hiro o. ; Kuroda, Makoto ; Omiya, Naoki. / Endoscopic features of lymphoid follicles using blue laser imaging (BLI) endoscopy in the colorectum and its association with chronic bowel symptoms. In: PLoS One. 2017 ; Vol. 12, No. 8.
@article{d89011db0e1d4817a233f8be8ffd8467,
title = "Endoscopic features of lymphoid follicles using blue laser imaging (BLI) endoscopy in the colorectum and its association with chronic bowel symptoms",
abstract = "Background/Aim: In the colorectum, lymphoid follicles hyperplasia (LH) is sometimes observed as small, round, yellowish-white nodules. The novel image-enhanced endoscopy system named blue laser imaging (BLI) provides enhanced the contrast of surface vessels using lasers for light illumination. We investigated the endoscopic features of LH observed by using BLI endoscopy and its association with chronic bowel symptoms. Patients/Methods: 300 participants undergoing colonoscopy for various indications were enrolled. Entire colorectum was observed by using BLI-bright mode with non-magnification view. LH was defined as well demarcated white nodules. Elevated LH with erythema was distinguished as LH severe. Results: LHs were observed more clearly by using BLI-bright mode compared to conventional white light colonoscopy and were also histologically confirmed as intense infiltration of lymphocytes or plasmacytes. LH was observed in 134 subjects (44.6{\%}) and 67 (22.3{\%}) were LH severe. LH was associated younger age (Odds ratio (OR) = 1.05, 95{\%}Confidence Interval (95{\%}CI) = 1.03–1.07, P<0.0001) and chronic bowel symptoms including constipation, hard stools, diarrhea and loose stools (all LH: OR = 4.03, 95{\%}CI = 2.36–6.89, P<0.0001, LH severe: OR = 5.31, 95{\%}CI = 2.64–10.71, P<0.0001). LH severe was closely associated with both constipation associated symptoms (OR = 3.94, 95{\%}CI = 1.79–8.66, P = 0.0007) and diarrhea associated symptoms (OR = 5.22, 95{\%}CI = 2.09–13.05, P = 0.0004). In particular, LH severe in the ascending colon was strongly associated with bowel symptoms (P<0.0001). Conclusion: LH, visualized by using BLI endoscopy was associated with bowel symptom, raising the possibility of pathogenic role of this endoscopic finding in the functional lower gastrointestinal disorders.",
author = "Tomomitsu Tahara and Kazuya Takahama and Sayumi Tahara and Dai Yoshida and Noriyuki Horiguchi and Tomohiko Kawamura and Masaaki Okubo and Mitsuo Nagasaka and Yoshihito Nakagawa and Makoto Urano and Tomoyuki Shibata and Tetsuya Tuskamoto and Ieda, {Hiro o.} and Makoto Kuroda and Naoki Omiya",
year = "2017",
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volume = "12",
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Tahara, T, Takahama, K, Tahara, S, Yoshida, D, Horiguchi, N, Kawamura, T, Okubo, M, Nagasaka, M, Nakagawa, Y, Urano, M, Shibata, T, Tuskamoto, T, Ieda, HO, Kuroda, M & Omiya, N 2017, 'Endoscopic features of lymphoid follicles using blue laser imaging (BLI) endoscopy in the colorectum and its association with chronic bowel symptoms', PLoS One, vol. 12, no. 8, e0182224. https://doi.org/10.1371/journal.pone.0182224

Endoscopic features of lymphoid follicles using blue laser imaging (BLI) endoscopy in the colorectum and its association with chronic bowel symptoms. / Tahara, Tomomitsu; Takahama, Kazuya; Tahara, Sayumi; Yoshida, Dai; Horiguchi, Noriyuki; Kawamura, Tomohiko; Okubo, Masaaki; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Urano, Makoto; Shibata, Tomoyuki; Tuskamoto, Tetsuya; Ieda, Hiro o.; Kuroda, Makoto; Omiya, Naoki.

In: PLoS One, Vol. 12, No. 8, e0182224, 01.08.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endoscopic features of lymphoid follicles using blue laser imaging (BLI) endoscopy in the colorectum and its association with chronic bowel symptoms

AU - Tahara, Tomomitsu

AU - Takahama, Kazuya

AU - Tahara, Sayumi

AU - Yoshida, Dai

AU - Horiguchi, Noriyuki

AU - Kawamura, Tomohiko

AU - Okubo, Masaaki

AU - Nagasaka, Mitsuo

AU - Nakagawa, Yoshihito

AU - Urano, Makoto

AU - Shibata, Tomoyuki

AU - Tuskamoto, Tetsuya

AU - Ieda, Hiro o.

AU - Kuroda, Makoto

AU - Omiya, Naoki

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background/Aim: In the colorectum, lymphoid follicles hyperplasia (LH) is sometimes observed as small, round, yellowish-white nodules. The novel image-enhanced endoscopy system named blue laser imaging (BLI) provides enhanced the contrast of surface vessels using lasers for light illumination. We investigated the endoscopic features of LH observed by using BLI endoscopy and its association with chronic bowel symptoms. Patients/Methods: 300 participants undergoing colonoscopy for various indications were enrolled. Entire colorectum was observed by using BLI-bright mode with non-magnification view. LH was defined as well demarcated white nodules. Elevated LH with erythema was distinguished as LH severe. Results: LHs were observed more clearly by using BLI-bright mode compared to conventional white light colonoscopy and were also histologically confirmed as intense infiltration of lymphocytes or plasmacytes. LH was observed in 134 subjects (44.6%) and 67 (22.3%) were LH severe. LH was associated younger age (Odds ratio (OR) = 1.05, 95%Confidence Interval (95%CI) = 1.03–1.07, P<0.0001) and chronic bowel symptoms including constipation, hard stools, diarrhea and loose stools (all LH: OR = 4.03, 95%CI = 2.36–6.89, P<0.0001, LH severe: OR = 5.31, 95%CI = 2.64–10.71, P<0.0001). LH severe was closely associated with both constipation associated symptoms (OR = 3.94, 95%CI = 1.79–8.66, P = 0.0007) and diarrhea associated symptoms (OR = 5.22, 95%CI = 2.09–13.05, P = 0.0004). In particular, LH severe in the ascending colon was strongly associated with bowel symptoms (P<0.0001). Conclusion: LH, visualized by using BLI endoscopy was associated with bowel symptom, raising the possibility of pathogenic role of this endoscopic finding in the functional lower gastrointestinal disorders.

AB - Background/Aim: In the colorectum, lymphoid follicles hyperplasia (LH) is sometimes observed as small, round, yellowish-white nodules. The novel image-enhanced endoscopy system named blue laser imaging (BLI) provides enhanced the contrast of surface vessels using lasers for light illumination. We investigated the endoscopic features of LH observed by using BLI endoscopy and its association with chronic bowel symptoms. Patients/Methods: 300 participants undergoing colonoscopy for various indications were enrolled. Entire colorectum was observed by using BLI-bright mode with non-magnification view. LH was defined as well demarcated white nodules. Elevated LH with erythema was distinguished as LH severe. Results: LHs were observed more clearly by using BLI-bright mode compared to conventional white light colonoscopy and were also histologically confirmed as intense infiltration of lymphocytes or plasmacytes. LH was observed in 134 subjects (44.6%) and 67 (22.3%) were LH severe. LH was associated younger age (Odds ratio (OR) = 1.05, 95%Confidence Interval (95%CI) = 1.03–1.07, P<0.0001) and chronic bowel symptoms including constipation, hard stools, diarrhea and loose stools (all LH: OR = 4.03, 95%CI = 2.36–6.89, P<0.0001, LH severe: OR = 5.31, 95%CI = 2.64–10.71, P<0.0001). LH severe was closely associated with both constipation associated symptoms (OR = 3.94, 95%CI = 1.79–8.66, P = 0.0007) and diarrhea associated symptoms (OR = 5.22, 95%CI = 2.09–13.05, P = 0.0004). In particular, LH severe in the ascending colon was strongly associated with bowel symptoms (P<0.0001). Conclusion: LH, visualized by using BLI endoscopy was associated with bowel symptom, raising the possibility of pathogenic role of this endoscopic finding in the functional lower gastrointestinal disorders.

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