| Theme |
Advancement in Diagnosis and Treatment for Duodenal Neoplasms |
| Title |
Endoscopic Diagnosis of Superficial Nonampullary Duodenal Epithelial Tumors |
| Author |
Kenichi Goda |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Akira Dobashi |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Yuko Hara |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Shunsuke Kamba |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Masakuni Kobayashi |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Hisao Tajiri |
Department of Endoscopy, The Jikei University School of Medicine / Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine |
| [ Summary ] |
To verify the current status of endoscopic diagnosis of superficial nonampullary duodenal epithelial tumors (SNADETs) in Japan, a multicenter case series questionnaire survey was conducted. The subjects of this survey were histologically confirmed as having SNADETs. These were endoscopically or surgically resected from 2007 to 2012. Nine endoscopists and a surgeon responded the questionnaires concerning endoscopic diagnosis of the SNADETs. This survey collected data on 364 patients with 396 SNADETs. Of the 396 SNADETs, 121 were histologically diagnosed as low grade dysplasia (LGD), 112 as high grade dysplasia (HGD), and 163 as superficial adenocarcinoma (SAC) including 153 mucosal carcinomas and 10 submucosal carcinomas. The total number of SNADETs increased from 125 in the first half to 271 in the second half of the period. Compared to LGD, a significantly greater number of HGD or SAC cases were found in tumors having a diameter ≥6 mm as well as those which were solitary or had red as a predominant color. Preoperative endoscopic diagnosis indicated significantly higher sensitivity and accuracy and significantly lower specificity for HGD or SAC of final histology than preoperative biopsy. Ten submucosal carcinomas had 0-Ⅰ or 0-Ⅱa+Ⅱc macroscopic type tumors with a red color. In conclusion, this multicenter case series study suggested the number of resected SNADETs had dramatically increased in Japan. A tumor diameter≥6 mm and a red color seemed to suggest tumors of HGD or SAC. Preoperative endoscopy may provide a more reliable diagnosis of final histology of HGD or SAC than preoperative biopsy. Further studies are warranted to establish endoscopic features of submucosal carcinomas. |