Non-ampullary Duodenal Adenocarcinoma Research Articles

Characteristics and risk factors for sporadic non-ampullary duodenal adenocarcinoma

Objectives: Despite the gradual increase in the incidence of non-ampullary duodenal adenocarcinoma (NADAC), the associated characteristics and risk factors remain poorly understood. The aim of this study was to clarify the clinical characteristics and risk factors of sporadic NADAC.Materials and methods: In this retrospective case-control study, we enrolled 156 Japanese NADAC patients with 160 lesions from our hospital’s cancer registry over 13 years. The patient demographics and clinical findings were compared to 468 age- and sex-matched controls selected from our medical health checkup recipients.Results: The ratio of men to women among the NADAC patients was 2:1, the median age was 64 years (range 31 to 90 years), the majority of the lesions were located in the second portion of the duodenum, and well-differentiated adenocarcinoma was the dominant histology. A univariate analysis revealed that smoking was a common risk factor for both men and women, whereas Helicobacter pylori (HP) infection and a history of colorectal cancer (CRC) were risk factors for the men. The multivariate analysis revealed that smoking, a history of CRC, and HP positivity were also individual risk factors for NADAC.Conclusions: Smoking, a history of CRC, and HP positivity were identified as risk factors for NADAC.

Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma

Endoscopic biopsy sampling for the diagnosis of duodenal adenocarcinoma is not perfect. We investigated the accuracy of biopsy specimen diagnoses of superficial nonampullary duodenal epithelial tumors (NADETs). Clinicopathologic data were retrospectively reviewed for 95 superficial NADETs from 95 patients who underwent endoscopic resection. Preoperative diagnoses based on biopsy specimens were compared with histologic diagnoses of resected specimens. Among the 21 lesions with biopsy specimen diagnoses of carcinoma, 12 (57.1%) were histologically diagnosed as adenomas after resection. Among the 74 lesions with biopsy specimen diagnoses of adenoma, 15 (20.3%) were histologically diagnosed as carcinomas after resection. The duodenal biopsy specimen predicted final histologic diagnoses of carcinoma with a sensitivity of 37.5% (95% CI, 18.8-59.4), specificity of 83.1% (95% CI, 72.3-91.0), accuracy of 71.6% (95% CI, 61.4-80.4), positive predictive value of 42.9% (95% CI, 21.8-66.0), and negative predictive value of 79.7% (95% CI, 68.8-88.2). Among 61 cases considered suitable for EMR, treatment modality was converted from EMR to endoscopic submucosal dissection because of the nonlifting sign in 15 cases (24.6%). The accuracy of duodenal biopsy sampling was relatively low. Duodenal biopsy sampling may induce unexpected fibrosis. New endoscopic modalities that can improve preoperative diagnosis yield of NADETs are eagerly awaited.

Usefulness and safety of endoscopic treatment for nonampullary duodenal adenoma and adenocarcinoma

Safety and efficacy data on endoscopic treatment of duodenal neoplasm are limited. We suggest the technical feasibility of endoscopic procedures by evaluating the results of endoscopic treatment for nonampullary duodenal adenoma and adenocarcinoma. Forty-five patients who underwent endoscopic treatment for nonampullary duodenal adenoma with or without malignant transformation between September 2003 and March 2012 were included. Endoscopic polypectomy of duodenal polyp (DPP), duodenal endoscopic mucosal resection (DEMR), and duodenal endoscopic submucosal dissection (DESD) were selected as endoscopic treatments for each lesion. Mean lesion size was 9.1 mm, and most lesions were located in the second portion of the duodenum. There were 40 adenomas and five early-stage adenocarcinomas arising from adenomas. Of the 45 duodenal neoplasms, five patients were treated with DPP, 33 with DEMR, and seven patients with a large duodenal lesion underwent DESD. Minimum of 1-year follow-up endoscopies were performed in 42 patients, excepting three patients treated after October 2011. Median follow-up was 24.8 months. Of the 45 patients, en bloc resection was performed in 43 (95.6%). A complete resection was performed in 41 patients (91.1%). No significant bleeding events occurred. Perforations occurred in three patients who underwent DESD. All perforations were noticed during the procedures and completely closed by endoscopic clipping. There was one recurrence at 6 months after DPP. Endoscopic treatment is minimally invasive management for duodenal adenomas and superficial adenocarcinomas. It would be helpful for medical doctors in the management of duodenal neoplasms.

SOX9 Is Highly Expressed in Nonampullary Duodenal Adenoma and Adenocarcinoma in Humans

Background/AimsSOX9 is a marker for stem cells in the intestine, and overexpression of SOX9 is found in gastric and colon cancer; however, the expression of SOX9 in nonampullary duodenal adenoma and adenocarcinoma has not yet been evaluated. This study aimed to investigate SOX9 expression in nonampullary duodenal adenoma and adenocarcinoma by immunohistochemistry.MethodsWe evaluated SOX9 expression in 43 clinical samples (nonampullary duodenal adenoma in 22 lesions and nonampullary duodenal adenocarcinoma in 21 lesions) resected under endoscopic mucosal resection or endoscopic submucosal dissection.ResultsSOX9 was expressed in part of the base of the normal duodenal mucosa surrounding adenomas and adenocarcinomas. In contrast, SOX9-positive cells were found in more than half of the crypts from the bottom part of the crypt in all of the 43 samples. Moreover, in 15 adenoma samples (68.2%) and 19 carcinoma samples (90.5%), SOX9 was expressed in more than three-quarters of the crypts from the bottom part of the crypt.ConclusionsSOX9 is overexpressed in nonampullary duodenal adenoma and adenocarcinoma in humans.

Sa1610 Technical Usefulness and Safety of Endoscopic Treatment for Nonampullary Duodenal Adenoma and Adenocarcinoma

Data on endoscopic treatment of duodenal neoplasm are limited to identify its safety and efficacy. We suggest the technical feasibility of the endoscopic procedures by evaluating the results of the endoscopic treatment for nonampullary duodenal adenoma and adenocarcinoma.

Non‐ampullary duodenal adenocarcinoma: Factors important for relapse and survival

Journal of Surgical OncologyVolume 100, Issue 5 p. 434-434 ErratumFree Access Non-ampullary duodenal adenocarcinoma: Factors important for relapse and survival Aaron Struck BS, Aaron Struck BS Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IndianaSearch for more papers by this authorThomas Howard MD, Thomas Howard MD Department of Surgery, Indiana University School of Medicine, Indianapolis, IndianaSearch for more papers by this authorElena G. Chiorean MD, Elena G. Chiorean MD Department of Medical Oncology, Indiana University School of Medicine, Indianapolis, IndianaSearch for more papers by this authorJeffrey M. Clarke MD, Jeffrey M. Clarke MD Department of Internal Medicine. Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorRobert Riffenburgh PhD, Robert Riffenburgh PhD Naval Medical Center San Diego, California San Diego State University, San Diego, CaliforniaSearch for more papers by this authorHiginia R. Cardenes MD, PhD, Corresponding Author Higinia R. Cardenes MD, PhD [email protected] Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IndianaProfessor of Clinical Radiation Oncology, Indiana University School of Medicine, Radiation Oncology Department, 535 Barnhill Dr, RT 041 Indianapolis, IN 46202. Fax: 317-274-2486.Search for more papers by this author Aaron Struck BS, Aaron Struck BS Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IndianaSearch for more papers by this authorThomas Howard MD, Thomas Howard MD Department of Surgery, Indiana University School of Medicine, Indianapolis, IndianaSearch for more papers by this authorElena G. Chiorean MD, Elena G. Chiorean MD Department of Medical Oncology, Indiana University School of Medicine, Indianapolis, IndianaSearch for more papers by this authorJeffrey M. Clarke MD, Jeffrey M. Clarke MD Department of Internal Medicine. Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorRobert Riffenburgh PhD, Robert Riffenburgh PhD Naval Medical Center San Diego, California San Diego State University, San Diego, CaliforniaSearch for more papers by this authorHiginia R. Cardenes MD, PhD, Corresponding Author Higinia R. Cardenes MD, PhD [email protected] Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IndianaProfessor of Clinical Radiation Oncology, Indiana University School of Medicine, Radiation Oncology Department, 535 Barnhill Dr, RT 041 Indianapolis, IN 46202. Fax: 317-274-2486.Search for more papers by this author First published: 20 August 2009 https://doi.org/10.1002/jso.21396AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume100, Issue51 October 2009Pages 434-434 RelatedInformation