散发性非壶腹十二指肠上皮肿瘤的自然史：我们能静观其变吗？
The natural history of sporadic non-ampullary duodenal epithelial tumors: Can we wait and see?
作者信息
Sakaguchi Yoshiki, Tsuji Yosuke, Ushiku Tetsuo, Kubota Dai, Sato Junichi, Obata Miho, Cho Rina, Nagao Sayaka, Sakuma Nobuyuki, Tamura Naoki, Miura Yuko, Fukagawa Kazushi, Ohki Daisuke, Mizutani Hiroya, Takeuchi Chihiro, Takahashi Yu, Minatsuki Chihiro, Niimi Keiko, Yamamichi Nobutake, Koike Kazuhiko
机构信息
Department of Gastroenterology Graduate School of Medicine The University of Tokyo Tokyo Japan.
Department of Pathology Graduate School of Medicine The University of Tokyo Tokyo Japan.
出版信息
DEN Open. 2021 Apr 21;1(1):e9. doi: 10.1002/deo2.9. eCollection 2021 Apr.
OBJECTIVES
The natural history of sporadic non-ampullary duodenal epithelial tumors (SNADETs) is poorly documented. The aim of this study was to evaluate the history of SNADETs in patients where immediate resection could not be performed.
METHODS
This is a single-center retrospective study of 86 consecutive cases of SNADETs who did not undergo immediate resection and were followed-up with upper gastrointestinal endoscopy for more than 6 months.
RESULTS
During a follow-up period of 36.8 (6.0-613.0) months, macroscopic progression was admitted in eight (9.3%). Of these, the final histology in four was adenocarcinoma, and three cases demonstrated submucosal invasion. Rates of macroscopic progression at 150 months after detection were 11.1%, 16.7%, and 30.0% for SNADETs <5 mm, <10 mm, and ≥10 mm, respectively.
CONCLUSION
The overall risk of SNADETs progressing to invasive cancer is low. However, changes in macroscopic size or shape of SNADETs signify a high risk of progression to invasive cancer.
目的
散发性非壶腹十二指肠上皮肿瘤（SNADETs）的自然病史鲜有文献记载。本研究旨在评估无法立即进行切除的SNADETs患者的病史。
方法
这是一项单中心回顾性研究，纳入了86例连续的SNADETs患者，这些患者未接受立即切除，并接受了超过6个月的上消化道内镜随访。
结果
在36.8（6.0 - 613.0）个月的随访期内，8例（9.3%）出现肉眼可见的进展。其中，4例最终组织学诊断为腺癌，3例显示有黏膜下浸润。检测后150个月时，直径<5 mm、<10 mm和≥10 mm的SNADETs的肉眼可见进展率分别为11.1%、16.7%和30.0%。
结论
SNADETs进展为浸润性癌的总体风险较低。然而，SNADETs的肉眼大小或形状改变表明进展为浸润性癌的风险较高。
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