Epidemiology, Risk Factors and Diagnosis of Small Bowel Adenocarcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Incidence and Risk Factors
2.1. Epidemiology
2.2. Carcinogenesis
2.3. Risk Factors for Small Bowel Adenocarcinoma
2.3.1. Lifestyle Factors
2.3.2. Genetic Syndromes
2.3.3. Other Predisposing Diseases
3. Clinical Presentation and Diagnostic Workup
3.1. Clinical Presentation
3.2. Initial Workup and Staging
3.3. Histological Diagnosis
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Siegel, R.L.; Miller, K.D.; Jemal, A. Cancer Statistics, 2019. CA Cancer J. Clin. 2019, 69, 7–34. [Google Scholar] [CrossRef] [Green Version]
- Chow, J.S.; Chen, C.C.; Ahsan, H.; Neugut, A.I. A Population-Based Study of the Incidence of Malignant Small Bowel Tumours: SEER, 1973–1990. Int. J. Epidemiol. 1996, 25, 722–728. [Google Scholar] [CrossRef] [Green Version]
- Lepage, C.; Bouvier, A.-M.; Manfredi, S.; Dancourt, V.; Faivre, J. Incidence and Management of Primary Malignant Small Bowel Cancers: A Well-Defined French Population Study. Am. J. Gastroenterol. 2006, 101, 2826–2832. [Google Scholar] [CrossRef] [PubMed]
- Bouvier, A.-M.; Robaszkiewicz, M.; Jooste, V.; Cariou, M.; Drouillard, A.; Bouvier, V.; Nousbaum, J.-B.; French Network of Cancer Registries (FRANCIM). Trends in Incidence of Small Bowel Cancer According to Histology: A Population-Based Study. J. Gastroenterol. 2020, 55, 181–188. [Google Scholar] [CrossRef] [PubMed]
- Legué, L.M.; Bernards, N.; Gerritse, S.L.; van Oudheusden, T.R.; de Hingh, I.H.J.T.; Creemers, G.-J.M.; Ten Tije, A.J.; Lemmens, V.E.P.P. Trends in Incidence, Treatment and Survival of Small Bowel Adenocarcinomas between 1999 and 2013: A Population-Based Study in The Netherlands. Acta Oncol. Stockh. Swed. 2016, 55, 1183–1189. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Faivre, J.; Trama, A.; De Angelis, R.; Elferink, M.; Siesling, S.; Audisio, R.; Bosset, J.F.; Cervantes, A.; Lepage, C.; RARECARE Working Group. Incidence, Prevalence and Survival of Patients with Rare Epithelial Digestive Cancers Diagnosed in Europe in 1995–2002. Eur. J. Cancer 2012, 48, 1417–1424. [Google Scholar] [CrossRef]
- Aparicio, T.; Zaanan, A.; Svrcek, M.; Laurent-Puig, P.; Carrere, N.; Manfredi, S.; Locher, C.; Afchain, P. Small Bowel Adenocarcinoma: Epidemiology, Risk Factors, Diagnosis and Treatment. Dig. Liver Dis. 2014, 46, 97–104. [Google Scholar] [CrossRef] [Green Version]
- Aparicio, T.; Svrcek, M.; Zaanan, A.; Beohou, E.; Laforest, A.; Afchain, P.; Mitry, E.; Taieb, J.; Di Fiore, F.; Gornet, J.-M.; et al. Small Bowel Adenocarcinoma Phenotyping, a Clinicobiological Prognostic Study. Br. J. Cancer 2013, 109, 3057–3066. [Google Scholar] [CrossRef] [Green Version]
- Hänninen, U.A.; Katainen, R.; Tanskanen, T.; Plaketti, R.-M.; Laine, R.; Hamberg, J.; Ristimäki, A.; Pukkala, E.; Taipale, M.; Mecklin, J.-P.; et al. Exome-Wide Somatic Mutation Characterization of Small Bowel Adenocarcinoma. PLoS Genet. 2018, 14, e1007200. [Google Scholar] [CrossRef] [Green Version]
- Aparicio, T.; Svrcek, M.; Henriques, J.; Afchain, P.; Lièvre, A.; Tougeron, D.; Gagniere, J.; Terrebonne, E.; Piessen, G.; Legoux, J.-L.; et al. Panel Gene Profiling of Small Bowel Adenocarcinoma: Results from the NADEGE Prospective Cohort. Int. J. Cancer 2021, 148, 1731–1742. [Google Scholar] [CrossRef]
- Schrock, A.B.; Devoe, C.E.; McWilliams, R.; Sun, J.; Aparicio, T.; Stephens, P.J.; Ross, J.S.; Wilson, R.; Miller, V.A.; Ali, S.M.; et al. Genomic Profiling of Small-Bowel Adenocarcinoma. JAMA Oncol. 2017, 3, 1546–1553. [Google Scholar] [CrossRef] [Green Version]
- Laforest, A.; Aparicio, T.; Zaanan, A.; Silva, F.P.; Didelot, A.; Desbeaux, A.; Le Corre, D.; Benhaim, L.; Pallier, K.; Aust, D.; et al. ERBB2 Gene as a Potential Therapeutic Target in Small Bowel Adenocarcinoma. Eur. J. Cancer 2014, 50, 1740–1746. [Google Scholar] [CrossRef]
- Alvi, M.A.; McArt, D.G.; Kelly, P.; Fuchs, M.-A.; Alderdice, M.; McCabe, C.M.; Bingham, V.; McGready, C.; Tripathi, S.; Emmert-Streib, F.; et al. Comprehensive Molecular Pathology Analysis of Small Bowel Adenocarcinoma Reveals Novel Targets with Potential for Clinical Utility. Oncotarget 2015, 6, 20863–20874. [Google Scholar] [CrossRef] [Green Version]
- Overman, M.J.; Pozadzides, J.; Kopetz, S.; Wen, S.; Abbruzzese, J.L.; Wolff, R.A.; Wang, H. Immunophenotype and Molecular Characterisation of Adenocarcinoma of the Small Intestine. Br. J. Cancer 2010, 102, 144–150. [Google Scholar] [CrossRef] [Green Version]
- Adam, L.; San Lucas, F.A.; Fowler, R.; Yu, Y.; Wu, W.; Liu, Y.; Wang, H.; Menter, D.; Tetzlaff, M.T.; Ensor, J.; et al. DNA Sequencing of Small Bowel Adenocarcinomas Identifies Targetable Recurrent Mutations in the ERBB2 Signaling Pathway. Clin. Cancer Res. 2019, 25, 641–651. [Google Scholar] [CrossRef] [Green Version]
- Liao, X.; Li, G.; McBride, R.; Houldsworth, J.; Harpaz, N.; Polydorides, A.D. Clinicopathological and Molecular Characterisation of Crohn’s Disease-Associated Small Bowel Adenocarcinomas. J. Crohns Colitis 2020, 14, 287–294. [Google Scholar] [CrossRef]
- Svrcek, M.; Jourdan, F.; Sebbagh, N.; Couvelard, A.; Chatelain, D.; Mourra, N.; Olschwang, S.; Wendum, D.; Fléjou, J.-F. Immunohistochemical Analysis of Adenocarcinoma of the Small Intestine: A Tissue Microarray Study. J. Clin. Pathol. 2003, 56, 898–903. [Google Scholar] [CrossRef] [Green Version]
- Vanoli, A.; Grillo, F.; Guerini, C.; Neri, G.; Arpa, G.; Klersy, C.; Nesi, G.; Giuffrida, P.; Sampietro, G.; Ardizzone, S.; et al. Prognostic Role of Mismatch Repair Status, Histotype and High-Risk Pathologic Features in Stage II Small Bowel Adenocarcinomas. Ann. Surg. Oncol. 2021, 28, 1167–1177. [Google Scholar] [CrossRef]
- Schottenfeld, D.; Beebe-Dimmer, J.L.; Vigneau, F.D. The Epidemiology and Pathogenesis of Neoplasia in the Small Intestine. Ann. Epidemiol. 2009, 19, 58–69. [Google Scholar] [CrossRef] [Green Version]
- Sanders, L.M.; Henderson, C.E.; Hong, M.Y.; Barhoumi, R.; Burghardt, R.C.; Carroll, R.J.; Turner, N.D.; Chapkin, R.S.; Lupton, J.R. Pro-Oxidant Environment of the Colon Compared to the Small Intestine May Contribute to Greater Cancer Susceptibility. Cancer Lett. 2004, 208, 155–161. [Google Scholar] [CrossRef]
- Delaunoit, T.; Neczyporenko, F.; Limburg, P.J.; Erlichman, C. Pathogenesis and Risk Factors of Small Bowel Adenocarcinoma: A Colorectal Cancer Sibling? Am. J. Gastroenterol. 2005, 100, 703–710. [Google Scholar] [CrossRef]
- Aparicio, T.; Henriques, J.; Manfredi, S.; Tougeron, D.; Bouché, O.; Pezet, D.; Piessen, G.; Coriat, R.; Zaanan, A.; Legoux, J.-L.; et al. Small Bowel Adenocarcinoma: Results from a Nationwide Prospective ARCAD-NADEGE Cohort Study of 347 Patients. Int. J. Cancer 2020, 147, 967–977. [Google Scholar] [CrossRef]
- Wu, A.H.; Yu, M.C.; Mack, T.M. Smoking, Alcohol Use, Dietary Factors and Risk of Small Intestinal Adenocarcinoma. Int. J. Cancer 1997, 70, 512–517. [Google Scholar] [CrossRef]
- Kaerlev, L.; Teglbjaerg, P.S.; Sabroe, S.; Kolstad, H.A.; Ahrens, W.; Eriksson, M.; Guénel, P.; Hardell, L.; Launoy, G.; Merler, E.; et al. Is There an Association between Alcohol Intake or Smoking and Small Bowel Adenocarcinoma? Results from a European Multi-Center Case-Control Study. Cancer Causes Control CCC 2000, 11, 791–797. [Google Scholar] [CrossRef]
- Negri, E.; Bosetti, C.; La Vecchia, C.; Fioretti, F.; Conti, E.; Franceschi, S. Risk Factors for Adenocarcinoma of the Small Intestine. Int. J. Cancer 1999, 82, 171–174. [Google Scholar] [CrossRef]
- Cross, A.J.; Hollenbeck, A.R.; Park, Y. A Large Prospective Study of Risk Factors for Adenocarcinomas and Malignant Carcinoid Tumors of the Small Intestine. Cancer Causes Control CCC 2013, 24, 1737–1746. [Google Scholar] [CrossRef]
- Cross, A.J.; Leitzmann, M.F.; Subar, A.F.; Thompson, F.E.; Hollenbeck, A.R.; Schatzkin, A. A Prospective Study of Meat and Fat Intake in Relation to Small Intestinal Cancer. Cancer Res. 2008, 68, 9274–9279. [Google Scholar] [CrossRef] [Green Version]
- Bennett, C.M.; Coleman, H.G.; Veal, P.G.; Cantwell, M.M.; Lau, C.C.L.; Murray, L.J. Lifestyle Factors and Small Intestine Adenocarcinoma Risk: A Systematic Review and Meta-Analysis. Cancer Epidemiol. 2015, 39, 265–273. [Google Scholar] [CrossRef] [Green Version]
- Kaerlev, L.; Teglbjaerg, P.S.; Sabroe, S.; Kolstad, H.A.; Ahrens, W.; Eriksson, M.; González, A.L.; Guénel, P.; Hardell, L.; Launoy, G.; et al. Occupation and Small Bowel Adenocarcinoma: A European Case-Control Study. Occup. Environ. Med. 2000, 57, 760–766. [Google Scholar] [CrossRef] [Green Version]
- Bonadona, V.; Bonaïti, B.; Olschwang, S.; Grandjouan, S.; Huiart, L.; Longy, M.; Guimbaud, R.; Buecher, B.; Bignon, Y.-J.; Caron, O.; et al. Cancer Risks Associated with Germline Mutations in MLH1, MSH2, and MSH6 Genes in Lynch Syndrome. JAMA 2011, 305, 2304–2310. [Google Scholar] [CrossRef]
- Møller, P.; Seppälä, T.T.; Bernstein, I.; Holinski-Feder, E.; Sala, P.; Gareth Evans, D.; Lindblom, A.; Macrae, F.; Blanco, I.; Sijmons, R.H.; et al. Cancer Risk and Survival in Path_MMR Carriers by Gene and Gender up to 75 Years of Age: A Report from the Prospective Lynch Syndrome Database. Gut 2018, 67, 1306–1316. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Vasen, H.F.A.; Blanco, I.; Aktan-Collan, K.; Gopie, J.P.; Alonso, A.; Aretz, S.; Bernstein, I.; Bertario, L.; Burn, J.; Capella, G.; et al. Revised Guidelines for the Clinical Management of Lynch Syndrome (HNPCC): Recommendations by a Group of European Experts. Gut 2013, 62, 812–823. [Google Scholar] [CrossRef] [PubMed]
- Babba, T.; Schischmanoff, O.; Lagorce, C.; Wind, P.; Des Guetz, G.; Aparicio, T.; Benamouzig, R. Small Bowel Carcinoma Revealing HNPCC Syndrome. Gastroenterol. Clin. Biol. 2010, 34, 325–328. [Google Scholar] [CrossRef] [PubMed]
- Locher, C.; Batumona, B.; Afchain, P.; Carrère, N.; Samalin, E.; Cellier, C.; Aparicio, T.; Becouarn, Y.; Bedenne, L.; Michel, P.; et al. Small Bowel Adenocarcinoma: French Intergroup Clinical Practice Guidelines for Diagnosis, Treatments and Follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO). Dig. Liver Dis. 2018, 50, 15–19. [Google Scholar] [CrossRef] [Green Version]
- Benson, A.B.; Venook, A.P.; Al-Hawary, M.M.; Arain, M.A.; Chen, Y.-J.; Ciombor, K.K.; Cohen, S.A.; Cooper, H.S.; Deming, D.A.; Garrido-Laguna, I.; et al. Small Bowel Adenocarcinoma, Version 1.2020, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw. JNCCN 2019, 17, 1109–1133. [Google Scholar] [CrossRef]
- Gallagher, M.C.; Phillips, R.K.S.; Bulow, S. Surveillance and Management of Upper Gastrointestinal Disease in Familial Adenomatous Polyposis. Fam. Cancer 2006, 5, 263–273. [Google Scholar] [CrossRef]
- Jagelman, D.G.; DeCosse, J.J.; Bussey, H.J. Upper Gastrointestinal Cancer in Familial Adenomatous Polyposis. Lancet 1988, 331, 1149–1151. [Google Scholar] [CrossRef]
- Bülow, S.; Björk, J.; Christensen, I.J.; Fausa, O.; Järvinen, H.; Moesgaard, F.; Vasen, H.F.A.; DAF Study Group. Duodenal Adenomatosis in Familial Adenomatous Polyposis. Gut 2004, 53, 381–386. [Google Scholar] [CrossRef] [Green Version]
- Offerhaus, G.J.; Giardiello, F.M.; Krush, A.J.; Booker, S.V.; Tersmette, A.C.; Kelley, N.C.; Hamilton, S.R. The Risk of Upper Gastrointestinal Cancer in Familial Adenomatous Polyposis. Gastroenterology 1992, 102, 1980–1982. [Google Scholar] [CrossRef]
- Giardiello, F.M.; Brensinger, J.D.; Tersmette, A.C.; Goodman, S.N.; Petersen, G.M.; Booker, S.V.; Cruz-Correa, M.; Offerhaus, J.A. Very High Risk of Cancer in Familial Peutz-Jeghers Syndrome. Gastroenterology 2000, 119, 1447–1453. [Google Scholar] [CrossRef] [Green Version]
- Shenoy, S. Genetic Risks and Familial Associations of Small Bowel Carcinoma. World J. Gastrointest. Oncol. 2016, 8, 509–519. [Google Scholar] [CrossRef]
- Palascak-Juif, V.; Bouvier, A.M.; Cosnes, J.; Flourié, B.; Bouché, O.; Cadiot, G.; Lémann, M.; Bonaz, B.; Denet, C.; Marteau, P.; et al. Small Bowel Adenocarcinoma in Patients with Crohn’s Disease Compared with Small Bowel Adenocarcinoma de Novo. Inflamm. Bowel Dis. 2005, 11, 828–832. [Google Scholar] [CrossRef]
- Elriz, K.; Carrat, F.; Carbonnel, F.; Marthey, L.; Bouvier, A.M.; Beaugerie, L.; CESAME study group. Incidence, Presentation, and Prognosis of Small Bowel Adenocarcinoma in Patients with Small Bowel Crohn’s Disease: A Prospective Observational Study. Inflamm. Bowel Dis. 2013, 19, 1823–1826. [Google Scholar] [CrossRef]
- Piton, G.; Cosnes, J.; Monnet, E.; Beaugerie, L.; Seksik, P.; Savoye, G.; Cadiot, G.; Flourie, B.; Capelle, P.; Marteau, P.; et al. Risk Factors Associated with Small Bowel Adenocarcinoma in Crohn’s Disease: A Case-Control Study. Am. J. Gastroenterol. 2008, 103, 1730–1736. [Google Scholar] [CrossRef]
- Svrcek, M.; Piton, G.; Cosnes, J.; Beaugerie, L.; Vermeire, S.; Geboes, K.; Lemoine, A.; Cervera, P.; El-Murr, N.; Dumont, S.; et al. Small Bowel Adenocarcinomas Complicating Crohn’s Disease Are Associated with Dysplasia: A Pathological and Molecular Study. Inflamm. Bowel Dis. 2014, 20, 1584–1592. [Google Scholar] [CrossRef]
- Askling, J.; Linet, M.; Gridley, G.; Halstensen, T.S.; Ekström, K.; Ekbom, A. Cancer Incidence in a Population-Based Cohort of Individuals Hospitalized with Celiac Disease or Dermatitis Herpetiformis. Gastroenterology 2002, 123, 1428–1435. [Google Scholar] [CrossRef]
- Emilsson, L.; Semrad, C.; Lebwohl, B.; Green, P.H.R.; Ludvigsson, J.F. Risk of Small Bowel Adenocarcinoma, Adenomas, and Carcinoids in a Nationwide Cohort of Individuals With Celiac Disease. Gastroenterology 2020, 159, 1686–1694.e2. [Google Scholar] [CrossRef]
- Caio, G.; Volta, U.; Ursini, F.; Manfredini, R.; De Giorgio, R. Small Bowel Adenocarcinoma as a Complication of Celiac Disease: Clinical and Diagnostic Features. BMC Gastroenterol. 2019, 19, 45. [Google Scholar] [CrossRef] [Green Version]
- Dabaja, B.S.; Suki, D.; Pro, B.; Bonnen, M.; Ajani, J. Adenocarcinoma of the Small Bowel: Presentation, Prognostic Factors, and Outcome of 217 Patients. Cancer 2004, 101, 518–526. [Google Scholar] [CrossRef]
- Sakae, H.; Kanzaki, H.; Nasu, J.; Akimoto, Y.; Matsueda, K.; Yoshioka, M.; Nakagawa, M.; Hori, S.; Inoue, M.; Inaba, T.; et al. The Characteristics and Outcomes of Small Bowel Adenocarcinoma: A Multicentre Retrospective Observational Study. Br. J. Cancer 2017, 117, 1607–1613. [Google Scholar] [CrossRef]
- Hartmann, D.; Schmidt, H.; Bolz, G.; Schilling, D.; Kinzel, F.; Eickhoff, A.; Huschner, W.; Möller, K.; Jakobs, R.; Reitzig, P.; et al. A Prospective Two-Center Study Comparing Wireless Capsule Endoscopy with Intraoperative Enteroscopy in Patients with Obscure GI Bleeding. Gastrointest. Endosc. 2005, 61, 826–832. [Google Scholar] [CrossRef]
- Pennazio, M.; Santucci, R.; Rondonotti, E.; Abbiati, C.; Beccari, G.; Rossini, F.P.; De Franchis, R. Outcome of Patients with Obscure Gastrointestinal Bleeding after Capsule Endoscopy: Report of 100 Consecutive Cases. Gastroenterology 2004, 126, 643–653. [Google Scholar] [CrossRef]
- Kim, E.R. Roles of Capsule Endoscopy and Device-Assisted Enteroscopy in the Diagnosis and Treatment of Small-Bowel Tumors. Clin. Endosc. 2020, 53, 410–416. [Google Scholar] [CrossRef]
- Gupta, A.; Postgate, A.J.; Burling, D.; Ilangovan, R.; Marshall, M.; Phillips, R.K.S.; Clark, S.K.; Fraser, C.H. A Prospective Study of MR Enterography versus Capsule Endoscopy for the Surveillance of Adult Patients with Peutz-Jeghers Syndrome. AJR Am. J. Roentgenol. 2010, 195, 108–116. [Google Scholar] [CrossRef]
- Cheung, D.Y.; Kim, J.S.; Shim, K.-N.; Choi, M.-G.; Korean Gut Image Study Group. The Usefulness of Capsule Endoscopy for Small Bowel Tumors. Clin. Endosc. 2016, 49, 21–25. [Google Scholar] [CrossRef] [Green Version]
- Yang, C.-B.; Yu, N.; Jian, Y.-J.; Yu, Y.; Duan, H.-F.; Zhang, X.-R.; Ma, G.-M.; Guo, Y.; Duan, X. Spectral CT Imaging in the Differential Diagnosis of Small Bowel Adenocarcinoma From Primary Small Intestinal Lymphoma. Acad. Radiol. 2019, 26, 878–884. [Google Scholar] [CrossRef]
- Masselli, G.; Di Tola, M.; Casciani, E.; Polettini, E.; Laghi, F.; Monti, R.; Bernieri, M.G.; Gualdi, G. Diagnosis of Small-Bowel Diseases: Prospective Comparison of Multi-Detector Row CT Enterography with MR Enterography. Radiology 2016, 279, 420–431. [Google Scholar] [CrossRef]
- Hadithi, M.; Heine, G.D.N.; Jacobs, M.A.J.M.; van Bodegraven, A.A.; Mulder, C.J.J. A Prospective Study Comparing Video Capsule Endoscopy with Double-Balloon Enteroscopy in Patients with Obscure Gastrointestinal Bleeding. Am. J. Gastroenterol. 2006, 101, 52–57. [Google Scholar] [CrossRef]
- Saurin, J.-C.; Pilleul, F.; Soussan, E.B.; Manière, T.; D’Halluin, P.N.; Gaudric, M.; Cellier, C.; Heresbach, D.; Gaudin, J.-L.; Capsule Commission of the French Society of Digestive Endoscopy (SFED). Small-Bowel Capsule Endoscopy Diagnoses Early and Advanced Neoplasms in Asymptomatic Patients with Lynch Syndrome. Endoscopy 2010, 42, 1057–1062. [Google Scholar] [CrossRef]
- Haanstra, J.F.; Al-Toma, A.; Dekker, E.; Vanhoutvin, S.A.L.W.; Nagengast, F.M.; Mathus-Vliegen, E.M.; van Leerdam, M.E.; de Vos tot Nederveen Cappel, W.H.; Sanduleanu, S.; Veenendaal, R.A.; et al. Prevalence of Small-Bowel Neoplasia in Lynch Syndrome Assessed by Video Capsule Endoscopy. Gut 2015, 64, 1578–1583. [Google Scholar] [CrossRef]
- Cronin, C.G.; Lohan, D.G.; Browne, A.M.; Roche, C.; Murphy, J.M. Magnetic Resonance Enterography in the Evaluation of the Small Bowel. Semin. Roentgenol. 2009, 44, 237–243. [Google Scholar] [CrossRef] [PubMed]
- Nylund, K.; Ødegaard, S.; Hausken, T.; Folvik, G.; Lied, G.A.; Viola, I.; Hauser, H.; Gilja, O.-H. Sonography of the Small Intestine. World J. Gastroenterol. 2009, 15, 1319–1330. [Google Scholar] [CrossRef] [PubMed]
- Halfdanarson, T.R.; McWilliams, R.R.; Donohue, J.H.; Quevedo, J.F. A Single-Institution Experience with 491 Cases of Small Bowel Adenocarcinoma. Am. J. Surg. 2010, 199, 797–803. [Google Scholar] [CrossRef] [PubMed]
- Small Intestine. In AJCC Cancer Staging Manual, 8th ed.; Springer: Berlin/Heidelberg, Germany, 2017; pp. 221–234.
- Adsay, N.; Nagtegaal, I.; Reid, M. Non-Ampullary Adenocarcinoma. In WHO Classification of Tumours, Digestive System Tumours, 5th ed.; World Health Organization: Geneva, Switzerland, 2019; pp. 124–126. [Google Scholar]
- Adsay, N.; Reid, M. Ampullary Adenocarcinoma. In WHO Classification of Tumours, Digestive System Tumours, 5th ed.; World Health Organization: Geneva, Switzerland, 2019; pp. 127–130. [Google Scholar]
- Adsay, V.; Ohike, N.; Tajiri, T.; Kim, G.E.; Krasinskas, A.; Balci, S.; Bagci, P.; Basturk, O.; Bandyopadhyay, S.; Jang, K.-T.; et al. Ampullary Region Carcinomas: Definition and Site Specific Classification with Delineation of Four Clinicopathologically and Prognostically Distinct Subsets in an Analysis of 249 Cases. Am. J. Surg. Pathol. 2012, 36, 1592–1608. [Google Scholar] [CrossRef] [PubMed]
- Ushiku, T.; Arnason, T.; Fukayama, M.; Lauwers, G.Y. Extra-Ampullary Duodenal Adenocarcinoma. Am. J. Surg. Pathol. 2014, 38, 1484–1493. [Google Scholar] [CrossRef]
- Maguire, A.; Sheahan, K. Primary Small Bowel Adenomas and Adenocarcinomas-Recent Advances. Virchows Arch. Int. J. Pathol. 2018, 473, 265–273. [Google Scholar] [CrossRef]
- Perkins, G.; Svrcek, M.; Bouchet-Doumenq, C.; Voron, T.; Colussi, O.; Debove, C.; Merabtene, F.; Dumont, S.; Sauvanet, A.; Hammel, P.; et al. Can We Classify Ampullary Tumours Better? Clinical, Pathological and Molecular Features. Results of an AGEO Study. Br. J. Cancer 2019, 120, 697–702. [Google Scholar] [CrossRef] [Green Version]
Publication | N | KRAS Mutation | TP53 Mutation | PIK3CA Mutation | APC Mutation | SMAD 4 Mutation | ERBB2 Overexpression or Mutation | dMMR Phenotype |
---|---|---|---|---|---|---|---|---|
Aparicio et al. (2021) | 125 | 44% | 38% | 20% | 18% | 14% | 7% | 28% |
Hänninen et al. (2018) * | 91 | 47% | 48% | 9% | 24% | 15% | 14% | 14% |
Schrock et al. (2016) | 358 | 56% | 58% | 16% | 27% | 17% | 8% | 7% |
Laforest et al. (2014) | 83 | 43% | 41% | 9% | 13% | 9% | 12% | 21% |
Tumor Characteristics | No Predisposing Disease n = 278 | Crohn’s Disease n = 30 | Lynch Syndrome n = 24 | p-Value |
---|---|---|---|---|
Median age (range) | 64 (24–90) | 48 (33–82) | 56 (23–74) | <0.0001 |
Primary: Duodenum | 66.7% | 6.9% | 60.9% | <0.0001 |
Jejunum | 19.9% | 10.3% | 30.4% | |
Ileum | 13.4% | 82.8% | 8.7% | |
Differentiation: Well and moderate | 81.6% | 60.7% | 68.2% | 0.0166 |
Poorly differentiated | 18.4% | 39.3% | 31.8% |
Primary tumor (T) T0 There is no evidence of a primary tumor Tis Carcinoma in situ T1 Tumor invades the mucosa, muscularis mucosa or submucosa T1a Tumor invades the lamina propria or muscularis mucosa T1b Tumor invades the submucosa T2 Tumor invades the muscularis propria T3 Tumor invades the subserosa or into the non-peritonealized perimuscular tissue (mesentery or retroperitoneum) T4 Tumor perforates the visceral peritoneum (T4a) or directly invades other organs or structures (T4b), including:
|
Regional lymph nodes (N) N0 No regional lymph node metastasis N1 Metastasis in 1–2 regional lymph nodes N2 Metastasis in 3 or more regional lymph nodes |
Distant metastasis (M) M0 No distant metastasis M1 Distant metastasis |
Cancer staging Stage 0: Tis, N0, M0 Stage I: T1 or T2, N0, M0 Stage IIA: T3, N0, M0 Stage IIB: T4, N0, M0 Stage IIIA: any T, N1, M0 Stage IIIB: any T, N2, M0 Stage IV: any T, any N, M1 |
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Aparicio, T.; Pachev, A.; Laurent-Puig, P.; Svrcek, M. Epidemiology, Risk Factors and Diagnosis of Small Bowel Adenocarcinoma. Cancers 2022, 14, 2268. https://doi.org/10.3390/cancers14092268
Aparicio T, Pachev A, Laurent-Puig P, Svrcek M. Epidemiology, Risk Factors and Diagnosis of Small Bowel Adenocarcinoma. Cancers. 2022; 14(9):2268. https://doi.org/10.3390/cancers14092268
Chicago/Turabian StyleAparicio, Thomas, Atanas Pachev, Pierre Laurent-Puig, and Magali Svrcek. 2022. "Epidemiology, Risk Factors and Diagnosis of Small Bowel Adenocarcinoma" Cancers 14, no. 9: 2268. https://doi.org/10.3390/cancers14092268