Ampullary Neuroendocrine Neoplasm: Clinicopathological Characteristics and Novel Endoscopic Entity
Ampullary Neuroendocrine Neoplasm: Clinicopathological Characteristics and Novel Endoscopic Entity
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壶腹神经内分泌肿瘤：临床病理学特征和新型内镜实体
DOI：
10.1159/000525013
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Ogawa Y.
中科院分区：
文献类型：
--
作者：
Matsumoto K;Fujimori N;Hata Y;Minoda Y;Murakami M;Teramatsu K;Takamatsu Y;Takeno A;Oono T;Ihara E;Nakata K;Nakamura M;Yamamoto T;Koga Y;Oda Y;Ito T;Ogawa Y.
研究背景乏特壶腹神经内分泌肿瘤（neuroendocrine neoplasms of Vater，ampullary NEN）兼有胃肠道和胰胆（pancreatobiliary，PB）NEN的特点。然而，研究壶腹NEN的研究数量有限，难以阐明其独特的特征。本研究旨在阐明壶腹NEN的临床特点。MethodsWe入组了162例PB-NEN诊断九州大学医院2011年至2020年。回顾性分析其临床表现、病理诊断、治疗及预后。结果壶腹NEN 10例，胰腺NEN 149例。壶腹NEN病例包括4例1级神经内分泌肿瘤（NET G1），1例2级神经内分泌肿瘤（NET G2）和5例神经内分泌癌（NEC）。壶腹NEN的NEC和胆管炎发生率明显高于PanNEN。所有壶腹NET有一个粘膜下肿瘤样外观，确定了内镜超声引导下细针穿刺。我们采用内镜乳头切除术治疗小NET G1（< 10 mm），采用胰管切除术治疗大NET G1。术后无复发病例。所有壶腹NEC的内镜下表现为特征性的“火山口征”，类似于胃恶性淋巴瘤中的深部溃疡。手术切除4例，不能切除1例。两个病人谁进行了多学科治疗保持无复发超过2 years.ConclusionsEndoscopic结果显示壶腹NETs和NEC之间的可识别的区别。
BackgroundNeuroendocrine neoplasms of the ampulla of Vater (ampullary NEN) have features of both gastrointestinal and pancreato-biliary (PB) NEN. However, the limited number of studies examining ampullary NEN makes it difficult to clarify their unique characteristics. This study aimed to elucidate the clinical characteristics of ampullary NEN.MethodsWe enrolled 162 patients with PB-NEN diagnosed at Kyushu University Hospital between 2011 and 2020. Clinical features, pathological diagnoses, treatments, and prognoses were retrospectively analyzed. We also compared ampullary NEN with pancreatic NEN (PanNEN).ResultsWe analyzed 10 ampullary NEN cases and 149 PanNEN cases. The ampullary NEN cases consisted of 4 cases of neuroendocrine tumor Grade 1 (NET G1), 1 NET G2 (Grade 2), and 5 neuroendocrine carcinomas (NECs). The incidences of NEC and cholangitis were significantly higher in ampullary NEN than in PanNEN. All ampullary NETs had a submucosal tumor-like appearance, as identified by endoscopic ultrasound-guided fine needle aspiration. We treated small NET G1 (< 10 mm) with endoscopic papillectomy and large NET G1 with pancreaticoduodenectomy. There were no cases of recurrence after resection. All ampullary NECs presented with the characteristic endoscopic finding of a “crater sign” similar to deep-mining ulcers seen in gastric malignant lymphoma. Four cases underwent surgical resection, and 1 case was unresectable. Two patients who underwent multidisciplinary treatment were maintained without recurrence for over 2 years.ConclusionsEndoscopic findings showed identifiable distinctions between ampullary NETs and NECs.
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影响因子：
28.4
作者：
Dasari, Arvind;Shen, Chan;Yao, James C.
通讯作者：
Yao, James C.
影响因子：
2
作者：
Scheruebl, Hans;Jensen, Robert T.;Kloeppel, Gnter
通讯作者：
Kloeppel, Gnter
影响因子：
2.4
作者：
Yang K;Yun SP;Kim S;Shin N;Park DY;Seo HI
通讯作者：
Seo HI
影响因子：
6.3
作者：
Ito, Tetsuhide;Igarashi, Hisato;Shimatsu, Akira
通讯作者：
Shimatsu, Akira
采用内镜粘膜下剥离法，通过十二指肠镜成功整块切除乳头状神经内分泌肿瘤。
DOI：
10.1016/j.clinre.2012.03.007
发表时间：
2012
影响因子：
2.7
作者：
H. Yi;Chun;Y. Mou;Wei Liu;Jing Li;Qiongying Zhang;Rong Luo;Min Chen Chengwei Tang;B. Hu
通讯作者：
B. Hu