دورية أكاديمية

Prediction of the invasion depth of superficial nonampullary duodenal adenocarcinoma

التفاصيل البيبلوغرافية
العنوان: Prediction of the invasion depth of superficial nonampullary duodenal adenocarcinoma
المؤلفون: Morita, Yuki, Yoshimizu, Shoichi, Takamatsu, Manabu, Kawachi, Hiroshi, Nakano, Kaoru, Ikenoyama, Yohei, Tokai, Yoshitaka, Namikawa, Ken, Horiuchi, Yusuke, Ishiyama, Akiyoshi, Yoshio, Toshiyuki, Hirasawa, Toshiaki, Fujisaki, Junko
المصدر: Digestive Endoscopy ; ISSN 0915-5635 1443-1661
بيانات النشر: Wiley
سنة النشر: 2023
المجموعة: Wiley Online Library (Open Access Articles via Crossref)
الوصف: Objectives Distinguishing between intramucosal cancer and submucosal invasive cancer is vital for optimal treatment selection for patients with superficial nonampullary duodenal adenocarcinoma (SNADAC); however, standard diagnostic systems for diagnosing invasion depth are as yet undetermined. Methods Of 205 patients with SNADAC who underwent treatment at our institution between 2006 and 2022, 188 had intramucosal cancer and 17 had submucosal invasive cancer. The clinical, endoscopic, and pathological features used in the preoperative diagnosis of invasion depth and the diagnostic performance of endoscopic ultrasonography (EUS) were retrospectively analyzed in 85 patients. Results The oral side of the papilla tumor location, protruded or mixed macroscopic type, and moderately‐to‐poorly differentiated adenocarcinoma based on biopsy specimens were significantly more frequent in submucosal invasive cancer than in intramucosal cancer (88% vs. 48%; 94% vs. 42%; 47% vs. 0%, respectively). From the relationship between the endoscopic features and the submucosal invasive cancer incidence, submucosal invasion risk was stratified as: (i) low‐risk (risk, 2%), all lesions located on the anal side of the papilla and superficial macroscopic type on the oral side of the papilla; and (ii) high‐risk (risk, 23%), protruded or mixed macroscopic type on the oral side of the papilla. Based on the biopsy specimens, all eight patients with moderately‐to‐poorly differentiated adenocarcinoma had submucosal invasive cancer. Furthermore, EUS was not associated with invasion depth's diagnostic accuracy improvements. Conclusion Optimal treatment indications for SNADAC can be selected based on the risk factors of submucosal invasion by tumor location, macroscopic type, and biopsy diagnosis.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1111/den.14729
الإتاحة: https://doi.org/10.1111/den.14729Test
حقوق: http://onlinelibrary.wiley.com/termsAndConditions#vorTest
رقم الانضمام: edsbas.B364A24B
قاعدة البيانات: BASE