How I do it: Endoscopic diagnosis for superficial non-ampullary duodenal epithelial tumors

Atsushi Nakayama, Motohiko Kato, Yusaku Takatori, Masayuki Shimoda, Mari Mizutani, Koshiro Tsutsumi, Yoshiyuki Kiguchi, Teppei Akimoto, Motoki Sasaki, Makoto Mutaguchi, Kaoru Takabayashi, Tadateru Maehata, Yasutoshi Ochiai, Takanori Kanai, Naohisa Yahagi

Research output: Contribution to journalArticle

Abstract

There are no reports on detailed endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADET) except for relatively small case series. Herein, we conducted a prospective observational study to investigate the relationship between endoscopic findings and histopathological diagnosis of SNADET. A total of 163 SNADET diagnosed using magnified endoscopic examination with image-enhanced endoscopy (IEE-ME) were prospectively registered in this study. We investigated location, size, macroscopic type, color, and IEE-ME findings including surface structure (closed- or open-loop) and presence of white opaque substance (WOS) in SNADET. We analyzed association between these findings and histopathological diagnosis of SNADET based on the Vienna classification (VCL) using logistic regression analysis. In univariate analysis, lesion size, superficial structure, and WOS deposition showed statistical significance, and the oral side of the lesion location showed statistical tendency for association with VCL C4/5. In multivariate analysis, lesion size (odds ratio [OR], 2.92; 95% CI, 1.94–4.39; P < 0.05) and negative WOS (OR, 5.59; 95% CI, 1.72–18.1; P < 0.05) were significantly associated with VCL C4/5 lesions. Superficial structures with a closed-loop pattern on the surface showed statistical tendency for predicting VCL C4/5 lesions (OR, 2.15; 95% CI, 0.86–5.37; P = 0.10). Based on these findings, we concluded that negative WOS by IEE-ME and lesion size were independent predictors of VCL C4/5 SNADET. These factors may help us to understand of pathophysiology of SNADET and to select appropriate therapeutic strategies.

Original languageEnglish
JournalDigestive Endoscopy
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Neoplasms
Odds Ratio
Endoscopy
Observational Studies
Multivariate Analysis
Color
Logistic Models
Regression Analysis
Prospective Studies
Therapeutics

Keywords

  • adenoma
  • carcinoma
  • diagnosis
  • duodenal neoplasm
  • endoscopy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

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title = "How I do it: Endoscopic diagnosis for superficial non-ampullary duodenal epithelial tumors",
abstract = "There are no reports on detailed endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADET) except for relatively small case series. Herein, we conducted a prospective observational study to investigate the relationship between endoscopic findings and histopathological diagnosis of SNADET. A total of 163 SNADET diagnosed using magnified endoscopic examination with image-enhanced endoscopy (IEE-ME) were prospectively registered in this study. We investigated location, size, macroscopic type, color, and IEE-ME findings including surface structure (closed- or open-loop) and presence of white opaque substance (WOS) in SNADET. We analyzed association between these findings and histopathological diagnosis of SNADET based on the Vienna classification (VCL) using logistic regression analysis. In univariate analysis, lesion size, superficial structure, and WOS deposition showed statistical significance, and the oral side of the lesion location showed statistical tendency for association with VCL C4/5. In multivariate analysis, lesion size (odds ratio [OR], 2.92; 95{\%} CI, 1.94–4.39; P < 0.05) and negative WOS (OR, 5.59; 95{\%} CI, 1.72–18.1; P < 0.05) were significantly associated with VCL C4/5 lesions. Superficial structures with a closed-loop pattern on the surface showed statistical tendency for predicting VCL C4/5 lesions (OR, 2.15; 95{\%} CI, 0.86–5.37; P = 0.10). Based on these findings, we concluded that negative WOS by IEE-ME and lesion size were independent predictors of VCL C4/5 SNADET. These factors may help us to understand of pathophysiology of SNADET and to select appropriate therapeutic strategies.",
keywords = "adenoma, carcinoma, diagnosis, duodenal neoplasm, endoscopy",
author = "Atsushi Nakayama and Motohiko Kato and Yusaku Takatori and Masayuki Shimoda and Mari Mizutani and Koshiro Tsutsumi and Yoshiyuki Kiguchi and Teppei Akimoto and Motoki Sasaki and Makoto Mutaguchi and Kaoru Takabayashi and Tadateru Maehata and Yasutoshi Ochiai and Takanori Kanai and Naohisa Yahagi",
year = "2019",
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T2 - Endoscopic diagnosis for superficial non-ampullary duodenal epithelial tumors

AU - Nakayama, Atsushi

AU - Kato, Motohiko

AU - Takatori, Yusaku

AU - Shimoda, Masayuki

AU - Mizutani, Mari

AU - Tsutsumi, Koshiro

AU - Kiguchi, Yoshiyuki

AU - Akimoto, Teppei

AU - Sasaki, Motoki

AU - Mutaguchi, Makoto

AU - Takabayashi, Kaoru

AU - Maehata, Tadateru

AU - Ochiai, Yasutoshi

AU - Kanai, Takanori

AU - Yahagi, Naohisa

PY - 2019/1/1

Y1 - 2019/1/1

N2 - There are no reports on detailed endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADET) except for relatively small case series. Herein, we conducted a prospective observational study to investigate the relationship between endoscopic findings and histopathological diagnosis of SNADET. A total of 163 SNADET diagnosed using magnified endoscopic examination with image-enhanced endoscopy (IEE-ME) were prospectively registered in this study. We investigated location, size, macroscopic type, color, and IEE-ME findings including surface structure (closed- or open-loop) and presence of white opaque substance (WOS) in SNADET. We analyzed association between these findings and histopathological diagnosis of SNADET based on the Vienna classification (VCL) using logistic regression analysis. In univariate analysis, lesion size, superficial structure, and WOS deposition showed statistical significance, and the oral side of the lesion location showed statistical tendency for association with VCL C4/5. In multivariate analysis, lesion size (odds ratio [OR], 2.92; 95% CI, 1.94–4.39; P < 0.05) and negative WOS (OR, 5.59; 95% CI, 1.72–18.1; P < 0.05) were significantly associated with VCL C4/5 lesions. Superficial structures with a closed-loop pattern on the surface showed statistical tendency for predicting VCL C4/5 lesions (OR, 2.15; 95% CI, 0.86–5.37; P = 0.10). Based on these findings, we concluded that negative WOS by IEE-ME and lesion size were independent predictors of VCL C4/5 SNADET. These factors may help us to understand of pathophysiology of SNADET and to select appropriate therapeutic strategies.

AB - There are no reports on detailed endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADET) except for relatively small case series. Herein, we conducted a prospective observational study to investigate the relationship between endoscopic findings and histopathological diagnosis of SNADET. A total of 163 SNADET diagnosed using magnified endoscopic examination with image-enhanced endoscopy (IEE-ME) were prospectively registered in this study. We investigated location, size, macroscopic type, color, and IEE-ME findings including surface structure (closed- or open-loop) and presence of white opaque substance (WOS) in SNADET. We analyzed association between these findings and histopathological diagnosis of SNADET based on the Vienna classification (VCL) using logistic regression analysis. In univariate analysis, lesion size, superficial structure, and WOS deposition showed statistical significance, and the oral side of the lesion location showed statistical tendency for association with VCL C4/5. In multivariate analysis, lesion size (odds ratio [OR], 2.92; 95% CI, 1.94–4.39; P < 0.05) and negative WOS (OR, 5.59; 95% CI, 1.72–18.1; P < 0.05) were significantly associated with VCL C4/5 lesions. Superficial structures with a closed-loop pattern on the surface showed statistical tendency for predicting VCL C4/5 lesions (OR, 2.15; 95% CI, 0.86–5.37; P = 0.10). Based on these findings, we concluded that negative WOS by IEE-ME and lesion size were independent predictors of VCL C4/5 SNADET. These factors may help us to understand of pathophysiology of SNADET and to select appropriate therapeutic strategies.

KW - adenoma

KW - carcinoma

KW - diagnosis

KW - duodenal neoplasm

KW - endoscopy

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