Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors in Japan: Multicenter case series
Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors in Japan: Multicenter case series
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DOI：
10.1111/den.12277
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发表时间：
2014-04-01
影响因子：
5.3
通讯作者：
Abe, Noritsugu
中科院分区：
文献类型：
--
作者：
Goda, Kenichi;Kikuchi, Daisuke;Abe, Noritsugu
背景和AimTo验证目前的状态在日本内镜下诊断浅表非壶腹十二指肠上皮肿瘤（SNADET）的多中心病例系列通过问卷调查。MethodsNine内镜医师和一名外科医生回答了问卷调查SNADET内镜诊断。该调查的受试者是2007年至2012年经内镜或手术切除的组织学证实的SNADET。结果396例SNADET中，低度异型增生（LGD）121例，高度异型增生（HGD）112例，浅表腺癌（SAC）163例，其中黏膜癌153例，黏膜下癌10例。在调查期间的前半期，国家残疾人服务系统的总数为125个，后半期增至271个。与LGD相比，在直径>5 mm以及孤立或主要为红色的肿瘤中发现了显著更多数量的HGD或SAC。与术前活检相比，术前内镜诊断HGD或SAC的敏感性和准确性显著较高，而特异性显著较低。10例粘膜下癌具有0-I或0-IIa+IIc肉眼可见的红色肿瘤。结论这项多中心病例系列研究表明，日本切除的SNADET数量正在急剧增加。肿瘤直径>5 mm和红色是HGD或SAC的标志。与术前活检相比，术前内镜检查可提供更可靠的HGD或SAC最终组织学诊断。进一步的研究是必要的，以建立粘膜下癌的内镜特征。
Background and AimTo verify the current status in Japan on endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADET) by a multicenter case series through a questionnaire survey.MethodsNine endoscopists and a surgeon responded to a questionnaire on endoscopic diagnosis of SNADET. The subjects of this survey were histologically confirmed SNADET that were endoscopically or surgically resected from 2007 to 2012. This survey collected data of 364 patients with 396 SNADET.ResultsOf the 396 SNADET, 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. Total number of SNADET increased from 125 in the first half to 271 in the second half of the survey period. Compared to LGD, a significantly greater number of HGD or SAC was found in the tumors having a diameter >5 mm as well as solitary or predominantly red 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 red color.ConclusionsThis multicenter case series study suggested that the number of resected SNADET is dramatically increasing in Japan. Tumor diameter >5 mm and red color seemed to be signs for 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 for establishing endoscopic features of submucosal carcinoma.