Abstract
ObjectiveThe rare incidence of submucosal invasive non-ampullary duodenal carcinoma has led to scant information in literature; therefore, we compared the clinicopathological features between submucosal invasive carcinoma (SM-Ca), mucosal carcinoma (M-Ca), and advanced carcinoma (Ad-Ca).MaterialsWe retrospectively analyzed 165 patients with sporadic non-ampullary duodenal carcinomas (SNADCs) from four institutions between January 2003 and December 2018. The SNADCs were divided to three groups according to histological diagnosis: SM-Ca, M-Ca, and Ad-Ca. The clinicopathological characteristics and mucin phenotypes were compared between groups.ResultsAmong the 165 SNADCs, 11 (7%) were classified as SM-Ca, 70 (42%) as M-Ca, and 84 (51%) as Ad-Ca. We found that all SM-Ca (P = 0.013) and most Ad-Ca (P = 0.020) lesions were located on the oral-Vater; however, an almost equal distribution of M-Ca lesions was found between the oral- and anal-Vater. No significant difference was observed between the tumor diameter of M-Ca and SM-Ca; however, 45% (5/11) of SM-Ca were ≤10 mm. A total of 73% (8/11) of SM-Ca were classified as gastric phenotype and no lesions were classified as intestinal phenotype; whereas most M-Ca were classified as intestinal phenotype (67%, 8/12).ConclusionsSM-Ca lesions were all located on the oral-Vater and were highly associated with the gastric mucin phenotype, which were different from the features of most M-Ca.
Highlights
Superficial non-ampullary duodenal epithelial neoplasms (SNADEN) were rare [1,2]; most patients presented with the advanced form of the condition, duodenal adenocarcinoma [3,4]
We found that all submucosal invasive carcinoma (SM-Ca) (P = 0.013) and most advanced carcinoma (Ad-Ca) (P = 0.020) lesions were located on the oral-Vater; an almost equal distribution of mucosal carcinomas (M-Ca) lesions was found between the oral- and anal-Vater
SM-Ca lesions were all located on the oral-Vater and were highly associated with the gastric mucin phenotype, which were different from the features of most M-Ca
Summary
Superficial non-ampullary duodenal epithelial neoplasms (SNADEN) were rare [1,2]; most patients presented with the advanced form of the condition, duodenal adenocarcinoma [3,4]. Patients who progress from M-Ca to advanced carcinoma (Ad-Ca) should inevitably develop SM-Ca; the large discrepancy between the incidences of SM-CA and M-CA or Ad-Ca is contradictory. The unavailability of data regarding the relationship of these three conditions has led to poor investigations into the reason. Investigating this relationship will lead to a better understanding of the development and progression of non-ampullary duodenal cancers. This study aimed to elucidate the clinicopathological features of non-ampullary duodenal SM-Ca, focusing on the relationship between SM-Ca, M-Ca, and Ad-Ca
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