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

Satoshi Kinoshita, Toshihiro Nishizawa, Yasutoshi Ochiai, Toshio Uraoka, Teppei Akimoto, Ai Fujimoto, Tadateru Maehata, Osamu Goto, Takanori Kanai, Naohisa Yahagi

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Abstract

Background and Aims: 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). Methods: 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. Results: 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%). Conclusions: 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. (Gastrointest Endosc 2017;-:1-4.).

Original languageEnglish
JournalGastrointestinal Endoscopy
DOIs
Publication statusAccepted/In press - 2017

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Adenocarcinoma
Biopsy
Carcinoma
Adenoma
Neoplasms
Fibrosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma. / Kinoshita, Satoshi; Nishizawa, Toshihiro; Ochiai, Yasutoshi; Uraoka, Toshio; Akimoto, Teppei; Fujimoto, Ai; Maehata, Tadateru; Goto, Osamu; Kanai, Takanori; Yahagi, Naohisa.

In: Gastrointestinal Endoscopy, 2017.

Research output: Contribution to journalArticle

Kinoshita, Satoshi ; Nishizawa, Toshihiro ; Ochiai, Yasutoshi ; Uraoka, Toshio ; Akimoto, Teppei ; Fujimoto, Ai ; Maehata, Tadateru ; Goto, Osamu ; Kanai, Takanori ; Yahagi, Naohisa. / Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma. In: Gastrointestinal Endoscopy. 2017.
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abstract = "Background and Aims: 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). Methods: 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. Results: 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{\%}). Conclusions: 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. (Gastrointest Endosc 2017;-:1-4.).",
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AU - Ochiai, Yasutoshi

AU - Uraoka, Toshio

AU - Akimoto, Teppei

AU - Fujimoto, Ai

AU - Maehata, Tadateru

AU - Goto, Osamu

AU - Kanai, Takanori

AU - Yahagi, Naohisa

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N2 - Background and Aims: 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). Methods: 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. Results: 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%). Conclusions: 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. (Gastrointest Endosc 2017;-:1-4.).

AB - Background and Aims: 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). Methods: 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. Results: 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%). Conclusions: 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. (Gastrointest Endosc 2017;-:1-4.).

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