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Clinicopathological features of superficial non-ampurally duodenal epithelial tumor; gastric phenotype of histology correlates to higher malignant potency

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Abstract

Background

Superficial non-ampullary duodenal epithelial tumors (SNADETs) are relatively rare, but they are now being detected more frequently due to advances in endoscopic technology. Nevertheless, the pathological nature of SNADETs remains unclear and a management strategy for these tumors has not been established.

Methods

To elucidate the clinicopathological features, we conducted a retrospective analysis of 138 endoscopically resected SNADETs. Lesions were classified into two groups by histological grade according to the Vienna classification: category 3 (71 lesions, 51.4%) and category 4/5 (67 lesions, 48.6%).

Results

Compared with category 3 lesions, category 4/5 lesions were significantly more common in elderly patients (p < 0.001) and had a significantly larger tumor diameter (p = 0.001). Immunohistochemical analysis showed that category 4/5 lesions expressed MUC5AC (p = 0.002), MUC6 (p < 0.001), and p53 (p = 0.003) significantly more frequently and expressed CD10 (p = 0.002) and CDX2 (p = 0.029) significantly less frequently. Multivariate regression analysis showed that advanced age (p < 0.001), MUC6 expression (p = 0.001), and p53 expression (p = 0.004) were independent risk factors for a classification of category 4/5. In addition, advanced age (p = 0.010) and MUC5AC expression (p = 0.011) were identified as risk factors for lesions classified as category 4.2 (noninvasive carcinoma) or higher. All category 5 lesions expressed MUC5AC.

Conclusions

The gastric phenotype of MUC5AC and MUC6 may be linked to the malignant potential of SNADETs.

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Acknowledgments

The authors would like to thank the medical technologists of the Department of Pathology for technical assistance in this study. This study was supported by funding from Toranomon Hospital Tokyo, Japan.

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Authors and Affiliations

  1. Department of Gastroenterology, Toranomon Hospital, Tokyo, 105-8470, Japan

    Takahito Toba, Mitsuru Kaise, Kosuke Nomura, Yasutaka Kuribayashi, Masami Tanaka, Satoshi Yamashita, Tsukasa Furuhata, Daisuke Kikuchi, Akira Matsui, Toshifumi Mitani, Toshiro Iizuka & Shu Hoteya

  2. Department of Pathology, Toranomon Hospital, Tokyo, 105-8470, Japan

    Naoko Inoshita

  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center, Tokyo, 143-8541, Japan

    Takahito Toba

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  1. Takahito Toba
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  2. Naoko Inoshita
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Correspondence to Takahito Toba.

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Toba, T., Inoshita, N., Kaise, M. et al. Clinicopathological features of superficial non-ampurally duodenal epithelial tumor; gastric phenotype of histology correlates to higher malignant potency. J Gastroenterol 53, 64–70 (2018). https://doi.org/10.1007/s00535-017-1327-0

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  • DOI: https://doi.org/10.1007/s00535-017-1327-0

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