title: Lipid is absorbed in the stomach by epithelial neoplasms (adenomas and early cancers): a novel functional endoscopy technique.
abstract: OBJECTIVE
  The authors have successfully demonstrated that the white opaque substance (WOS) identified in gastric epithelial neoplasms is an accumulation of minute lipid droplets on the epithelial neoplasm. It is not known whether the lipid droplets originate from externally ingested lipids (typically foods). The purpose of this study was to investigate whether the oral ingestion of foods containing emulsified fats increases the density of the WOS in epithelial neoplasms.
  
  
  METHODS
  We examined 92 gastric epithelial neoplastic lesions in 89 patients. The patients were given emulsified fatty foods before the procedure, and magnifying endoscopy with narrow-band imaging (M-NBI) was used to image the lesions. An increase in WOS density after the ingestion of emulsified fatty foods was defined as a positive fat-loading test result. The patients were divided into the following groups: control group, no emulsified fat administered; group 1, fatty food administered 16 hours prior; group 3, fatty food administered both 16 and 4 hours prior. The proportion of positive fat-loading test results was determined in all groups.
  
  
  RESULTS
  The rates of positive fat-loading test results were as follows: control group, 9 %; group 1, 26 %; group 2, 52 %; group 3, 78 %. The increase in the rates of positive fat-loading test results in groups 2 and 3 relative to the rate in the control group was statistically significant (chi-squared test).
  
  
  CONCLUSIONS
  This study demonstrated for the first time that the ingestion of external lipids causes lipid droplets to aggregate in situ on the gastric epithelial neoplasm. These results can be used to develop a novel functional endoscopy technique that harnesses the lipid absorption capacity of neoplasms.
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Kensei
authors.initials: K
authors.lastname: Ohtsu
authors.affiliation: Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Yao
authors.affiliation: Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Matsunaga
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagahama
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Kanemitsu
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Matsushima
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Motochika
authors.initials: M
authors.lastname: Yasaka
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Fujiwara
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hisabe
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takaki
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Fumihito
authors.initials: F
authors.lastname: Hirai
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
authors.affiliation: Department of Nutrition, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Teruyo
authors.initials: T
authors.lastname: Hanada
authors.affiliation: Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Imamura
authors.affiliation: Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanabe
authors.affiliation: Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwashita
authors.affiliation: Clinical Research Center, Wakayama Medical University, Wakayama, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Shimokawa