Yoshimura Noboru, Goda Kenichi, Tajiri Hisao, Ikegami Masahiro, Nakayoshi Takashi, Kaise Mitsuru
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
Hepatogastroenterology. 2010 May-Jun;57(99-100):462-7.
BACKGROUND/AIMS: Endoscopic features of nonampullary duodenal adenomas and early adenocarcinomas are not well known. The aims of this study were to investigate the endoscopic features of the tumors using conventional endoscopy and narrow-band imaging magnified endoscopy, and to reveal the relationship between the endoscopic features and histological grades.
The study included 24 nonampullary duodenal adenomas and early adenocarcinomas in 22 patients who underwent conventional endoscopy and narrow-band imaging magnified endoscopy. The tumors were divided into histological groups according to the modified Vienna classification system.
The 24 tumors were 17 adenomas and 7 carcinomas in situ, and divided into 10 Category 3 and 14 Category 4 lesions. On conventional endoscopy, 22 of the 24 (92%) lesions, had a milk-white mucosa and the frequency of a marginal-type one was significantly higher for the Category 4 group (p = 0.028). On narrow-band imaging magnified endoscopy, all tumors had a heterogeneous pattern. The frequency of an obscure mucosal pattern and a network microvascular pattern was significantly higher for the Category 4 group (p = 0.024 and 0.001, respectively).
Narrow-band imaging magnified endoscopy following conventional endoscopy might be a promising approach to realizing lesions or predicting histological grade of nonampullary duodenal intraepithelial tumors.
背景/目的：非壶腹十二指肠腺瘤和早期腺癌的内镜特征尚不为人所知。本研究的目的是使用传统内镜和窄带成像放大内镜研究肿瘤的内镜特征，并揭示内镜特征与组织学分级之间的关系。
本研究纳入了22例接受传统内镜和窄带成像放大内镜检查的患者，其中有24个非壶腹十二指肠腺瘤和早期腺癌。根据改良的维也纳分类系统将肿瘤分为组织学组。
24个肿瘤中，17个为腺瘤，7个为原位癌，分为10个3类病变和14个4类病变。在传统内镜检查中，24个病变中有22个（92%）黏膜呈乳白色，4类病变边缘型的发生率显著更高（p = 0.028）。在窄带成像放大内镜检查中，所有肿瘤均呈现异质性模式。4类病变中黏膜模糊模式和微血管网络模式的发生率显著更高（分别为p = 0.024和0.001）。
传统内镜检查后进行窄带成像放大内镜检查可能是一种实现非壶腹十二指肠上皮内肿瘤病变识别或预测组织学分级的有前景的方法。
