Juntaro Matsuzaki1,2,3, Hidekazu Suzuki4, Masayuki Shimoda5, Hideki Mori1, Seiichiro Fukuhara1, Sawako Miyoshi1, Tatsuhiro Masaoka1, Yasushi Iwao2, Yae Kanai5,6, Takanori Kanai1. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. 2. Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan. 3. Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo, Japan. 4. Fellowship Training Center, Medical Education Center, Keio University School of Medicine, Tokyo, Japan. 5. Department of Pathology, Keio University School of Medicine, Tokyo, Japan. 6. Division of Molecular Pathology, National Cancer Center Research Institute, Tokyo, Japan.
Abstract
Background: Sporadic nonampullary duodenal adenocarcinoma is a rare malignant neoplasm in which poor prognosis is often associated with delayed diagnosis. Objective: A case-control study was designed to evaluate the clinical and endoscopic characteristics of patients with nonampullary duodenal epithelial tumours (NADETs). Methods: Patients with NADETs were chronologically divided into a discovery and a validation sets. Two age- and sex-matched control individuals for each case in the discovery set were randomly selected from individuals without NADET. A prediction model for the presence of NADET, constructed in the discovery set, was evaluated in the validation set. Results: In total, 368 adenomas, 81 adenocarcinomas, and 314 controls were analysed. Current smoking, Barrett oesophagus, fundic gland polyps, history of malignant disease, and absence of dyslipidaemia were independently associated with the presence of NADET. The combination of these five factors enabled significant discrimination for NADET in the bulb with a sensitivity of 0.81 in the validation set. We also showed that duodenal adenocarcinomas in the bulb had greater invasive potential than adenocarcinomas in the second portion. Conclusion: The presence of a duodenal tumour in the bulb could be predicted by clinical and endoscopic findings, which helps improve the prognosis and quality of life of patients.
Background: Sporadic nonampullary duodenal adenocarcinoma is a rare malignant neoplasm in which poor prognosis is often associated with delayed diagnosis. Objective: A case-control study was designed to evaluate the clinical and endoscopic characteristics of patients with nonampullary duodenal epithelial tumours (NADETs). Methods:Patients with NADETs were chronologically divided into a discovery and a validation sets. Two age- and sex-matched control individuals for each case in the discovery set were randomly selected from individuals without NADET. A prediction model for the presence of NADET, constructed in the discovery set, was evaluated in the validation set. Results: In total, 368 adenomas, 81 adenocarcinomas, and 314 controls were analysed. Current smoking, Barrett oesophagus, fundic gland polyps, history of malignant disease, and absence of dyslipidaemia were independently associated with the presence of NADET. The combination of these five factors enabled significant discrimination for NADET in the bulb with a sensitivity of 0.81 in the validation set. We also showed that duodenal adenocarcinomas in the bulb had greater invasive potential than adenocarcinomas in the second portion. Conclusion: The presence of a duodenal tumour in the bulb could be predicted by clinical and endoscopic findings, which helps improve the prognosis and quality of life of patients.
Authors: Xiaofang Huo; Xi Zhang; Chunhua Yu; Edaire Cheng; Qiuyang Zhang; Kerry B Dunbar; Thai H Pham; John P Lynch; David H Wang; Robert S Bresalier; Stuart J Spechler; Rhonda F Souza Journal: Gut Date: 2017-04-25 Impact factor: 23.059
Authors: Karl Y Bilimoria; David J Bentrem; Jeffrey D Wayne; Clifford Y Ko; Charles L Bennett; Mark S Talamonti Journal: Ann Surg Date: 2009-01 Impact factor: 12.969