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Search Results (4)

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Keywords = superficial non-ampullary duodenal epithelial tumor

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9 pages, 383 KiB  
Article
Site of Biopsy and Its Accuracy in Preoperative Diagnosis of Superficial Nonampullary Duodenal Epithelial Tumors: Retrospective Study
by Yukihisa Fujinaga, Akira Mitoro, Hitoshi Mori, Satoshi Iwai, Takahiro Kubo, Misako Tanaka, Aritoshi Koizumi, Fumimasa Tomooka, Shohei Asada, Koh Kitagawa, Norihisa Nishimura, Shinya Sato, Kosuke Kaji, Tadashi Namisaki and Hitoshi Yoshiji
J. Clin. Med. 2025, 14(8), 2579; https://doi.org/10.3390/jcm14082579 - 9 Apr 2025
Viewed by 434
Abstract
Background/Objectives: As endoscopy is increasingly being used to diagnose superficial nonampullary duodenal epithelial tumors (SNADETs), there is a growing need for their early detection and minimally invasive treatment. This study investigated the diagnostic accuracy of biopsy specimens for SNADETs. Methods: We conducted a [...] Read more.
Background/Objectives: As endoscopy is increasingly being used to diagnose superficial nonampullary duodenal epithelial tumors (SNADETs), there is a growing need for their early detection and minimally invasive treatment. This study investigated the diagnostic accuracy of biopsy specimens for SNADETs. Methods: We conducted a retrospective analysis of clinicopathologic data from 98 patients with SNADETs who had undergone endoscopic resection. The presurgical diagnosis, based on biopsy specimens, was compared with the histological diagnosis of the excised specimens. Results: Herein, preoperative biopsies were performed on 98 SNADETs specimens from 91 patients. Of the 68 adenomas and 30 carcinomas, 22.4% adenomas were later found to be carcinomas. Carcinoma biopsy diagnosis sensitivity, specificity, and accuracy were 54.6%, 80.0%, and 71.4%, respectively. Biopsy accuracy for carcinoma differed significantly by location to the papilla of Vater (p = 0.0455). The preoperative biopsy diagnostics’ sensitivity, specificity, and accuracy for oral and anal carcinomas to Vater papilla were 69.2%, 92.0%, and 84.2% and 42.1%, 73.2%, and 63.3%, respectively. Conclusions: The diagnostic accuracy of biopsy for SNADETs was low; however, it was higher on the oral side than the anal side of the papilla of Vater. The biopsy of duodenal lesions should be performed after an endoscopic examination, considering their location and reducing the risks of fibrosis. Full article
(This article belongs to the Special Issue Endoscopic Diagnosis and Treatments of Gastrointestinal Diseases)
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10 pages, 209 KiB  
Article
Safety of Duodenal Endoscopic Submucosal Dissection for Superficial Non-Ampullary Duodenal Epithelial Tumor: A Single-Center Study in the United States
by Mako Koseki, Makoto Nishimura, Tarek Nammour, Kana Chin, Sayaka Nagao, Jacques C. Beauvais and Mark A. Schattner
J. Clin. Med. 2024, 13(1), 143; https://doi.org/10.3390/jcm13010143 - 27 Dec 2023
Cited by 4 | Viewed by 1578
Abstract
Endoscopic submucosal dissection (ESD) of superficial non—ampullary duodenal epithelial tumors (SNADETs) is associated with a high rate of en bloc resection and low rate of recurrence. However, in the United States, SNADETs are predominantly managed using endoscopic mucosal resection (EMR) or surgery because [...] Read more.
Endoscopic submucosal dissection (ESD) of superficial non—ampullary duodenal epithelial tumors (SNADETs) is associated with a high rate of en bloc resection and low rate of recurrence. However, in the United States, SNADETs are predominantly managed using endoscopic mucosal resection (EMR) or surgery because the feasibility and safety of duodenal ESD have not yet been established. In this study, we analyzed the outcomes of duodenal ESD for SNADETs. This single—center retrospective study reviewed the data of patients who underwent ESD for SNADETs between June 2018 and August 2023. Baseline patient characteristics, histopathology of the resected lesions, adverse events, and recurrence rates were evaluated. The primary outcome measures were en bloc resection, complications, and recurrence rate. Thirty ESD procedures were performed on 24 patients. All 30 lesions were adenomas, with no cancerous lesions. The en bloc resection rate and R0 resection rates were both 53%. There were no cases of procedure-associated perforation. Post-ESD bleeding was observed in six cases. No ESD—related mortality was observed. The recurrence rate was 14% in 1 year follow up, and 28% the during all follow-up period. ESD is a safe option for SNADET in the United States; however further comparative studies are necessary to determine the optimal procedure for North American populations. Full article
(This article belongs to the Special Issue Gastrointestinal Endoscopy: Clinical Advances in Diagnosis and Treatment)
10 pages, 447 KiB  
Opinion
Issues and Prospects of Current Endoscopic Treatment Strategy for Superficial Non-Ampullary Duodenal Epithelial Tumors
by Tetsuya Suwa, Masao Yoshida and Hiroyuki Ono
Curr. Oncol. 2022, 29(10), 6816-6825; https://doi.org/10.3390/curroncol29100537 - 22 Sep 2022
Cited by 3 | Viewed by 2537
Abstract
An increasing number of duodenal tumors are being diagnosed over the years, leading to increased confusion regarding the choice of treatment options. Small-to-large tumors and histological types vary from adenoma to carcinoma, and treatment methods may need to be selected according to lesion [...] Read more.
An increasing number of duodenal tumors are being diagnosed over the years, leading to increased confusion regarding the choice of treatment options. Small-to-large tumors and histological types vary from adenoma to carcinoma, and treatment methods may need to be selected according to lesion characteristics. Because of its anatomic characteristics, complications are more likely to occur in the duodenum than in other gastrointestinal organs. Several reports have described the outcomes of conventional endoscopic mucosal resection, endoscopic submucosal dissection, cold snare polypectomy, underwater endoscopic mucosal resection, endoscopic full-thickness resection, and laparoscopic and endoscopic cooperative surgery for duodenal tumors. However, even in the guidelines set out by various countries, only the treatment methods are listed, and no clear treatment strategies are provided. Although there are few reports with a sufficiently high level of evidence, considering the currently available treatment options is essential. In this report, we reviewed previous reports on each treatment strategy, discussed the current issues and prospects, and proposed the best possible treatment strategy. Full article
(This article belongs to the Special Issue Endoscopic Diagnosis and Treatment of Gastrointestinal Cancer)
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10 pages, 6607 KiB  
Article
Association between Endoscopic Milk-White Mucosa, Epithelial Intracellular Lipid Droplets, and Histological Grade of Superficial Non-Ampullary Duodenal Epithelial Tumors
by Yuko Hara, Kenichi Goda, Shinichi Hirooka, Takehiro Mitsuishi, Masahiro Ikegami and Kazuki Sumiyama
Diagnostics 2021, 11(5), 769; https://doi.org/10.3390/diagnostics11050769 - 25 Apr 2021
Cited by 9 | Viewed by 3909
Abstract
We previously reported that superficial non-ampullary duodenal tumors (SNADETs) commonly had a whitish mucosal surface, named milk-white mucosa (MWM). The aim of this study was to evaluate the association of MWM with epithelial intracellular lipid droplets (immunohistochemically stained by adipose differentiation-related protein (ADRP)) [...] Read more.
We previously reported that superficial non-ampullary duodenal tumors (SNADETs) commonly had a whitish mucosal surface, named milk-white mucosa (MWM). The aim of this study was to evaluate the association of MWM with epithelial intracellular lipid droplets (immunohistochemically stained by adipose differentiation-related protein (ADRP)) and histological tumor grades. We reviewed endoscopic images and the histopathology of SNADETs resected en bloc endoscopically. We analyzed the correlation between the positive rates of endoscopic MWM in preoperative endoscopy and resected specimens, and ADRP-positive rates in the resected specimens. Associations between the MWM-positive rates and tumor grades, high-grade intraepithelial neoplasia (HGIN)/intramucosal carcinoma (IC), and low-grade intraepithelial neoplasia (LGIN) were analyzed. All the 92 SNADETs analyzed were <20 mm and histologically classified into 39 HGIN/IC and 53 LGIN. Spearman’s rank correlation coefficient showed a significant correlation between MWM-positive and ADRP-positive rates (p < 0.001). MWM-positive rates were significantly lower in the HGIN/IC than in the LGIN in preoperative endoscopy (p < 0.001) and resected specimens (p = 0.02). Our results suggest that endoscopic MWM is closely associated with epithelial intracellular lipid droplets and that the MWM-positive rate may be a predictor of histological grade in small SNADETs. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gastrointestinal Diseases: Using Digestive Endoscopy)
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