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活检部位及其在浅表非壶腹十二指肠上皮肿瘤术前诊断中的准确性:回顾性研究

Site of Biopsy and Its Accuracy in Preoperative Diagnosis of Superficial Nonampullary Duodenal Epithelial Tumors: Retrospective Study.

作者信息

Fujinaga Yukihisa, Mitoro Akira, Mori Hitoshi, Iwai Satoshi, Kubo Takahiro, Tanaka Misako, Koizumi Aritoshi, Tomooka Fumimasa, Asada Shohei, Kitagawa Koh, Nishimura Norihisa, Sato Shinya, Kaji Kosuke, Namisaki Tadashi, Yoshiji Hitoshi

机构信息

Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan.

Division of Endoscopy, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan.

出版信息

J Clin Med. 2025 Apr 9;14(8):2579. doi: 10.3390/jcm14082579.

DOI:10.3390/jcm14082579
PMID:40283410
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12027901/
Abstract

As endoscopy is increasingly being used to diagnose superficial nonampullary duodenal epithelial tumors (SNADETs), there is a growing need for their early detection and minimally invasive treatment. This study investigated the diagnostic accuracy of biopsy specimens for SNADETs. We conducted a retrospective analysis of clinicopathologic data from 98 patients with SNADETs who had undergone endoscopic resection. The presurgical diagnosis, based on biopsy specimens, was compared with the histological diagnosis of the excised specimens. Herein, preoperative biopsies were performed on 98 SNADETs specimens from 91 patients. Of the 68 adenomas and 30 carcinomas, 22.4% adenomas were later found to be carcinomas. Carcinoma biopsy diagnosis sensitivity, specificity, and accuracy were 54.6%, 80.0%, and 71.4%, respectively. Biopsy accuracy for carcinoma differed significantly by location to the papilla of Vater ( = 0.0455). The preoperative biopsy diagnostics' sensitivity, specificity, and accuracy for oral and anal carcinomas to Vater papilla were 69.2%, 92.0%, and 84.2% and 42.1%, 73.2%, and 63.3%, respectively. The diagnostic accuracy of biopsy for SNADETs was low; however, it was higher on the oral side than the anal side of the papilla of Vater. The biopsy of duodenal lesions should be performed after an endoscopic examination, considering their location and reducing the risks of fibrosis.

摘要

随着内镜检查越来越多地用于诊断浅表非壶腹十二指肠上皮肿瘤(SNADETs),对其早期检测和微创治疗的需求日益增加。本研究调查了SNADETs活检标本的诊断准确性。我们对98例接受内镜切除的SNADETs患者的临床病理数据进行了回顾性分析。将基于活检标本的术前诊断与切除标本的组织学诊断进行比较。在此,对91例患者的98个SNADETs标本进行了术前活检。在68例腺瘤和30例癌中,后来发现22.4%的腺瘤为癌。癌活检诊断的敏感性、特异性和准确性分别为54.6%、80.0%和71.4%。癌的活检准确性因距Vater乳头的位置不同而有显著差异( = 0.0455)。术前活检诊断对Vater乳头口侧和肛侧癌的敏感性、特异性和准确性分别为69.2%、92.0%和84.2%以及42.1%、73.2%和63.3%。SNADETs活检的诊断准确性较低;然而,在Vater乳头的口侧比肛侧更高。十二指肠病变的活检应在内镜检查后进行,考虑其位置并降低纤维化风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8adc/12027901/4f1e8c4f6e1e/jcm-14-02579-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8adc/12027901/4f1e8c4f6e1e/jcm-14-02579-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8adc/12027901/4f1e8c4f6e1e/jcm-14-02579-g001.jpg

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本文引用的文献

1
Non-atrophic gastric mucosa is an independently associated factor for superficial non-ampullary duodenal epithelial tumors: a multicenter, matched, case-control study.非萎缩性胃黏膜是浅表非壶腹十二指肠上皮肿瘤的独立相关因素:一项多中心、匹配的病例对照研究。
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Outcomes of endoscopic resection for superficial duodenal tumors: 10 years' experience in 18 Japanese high volume centers.内镜切除治疗十二指肠浅表肿瘤的疗效:18 家日本高容量中心 10 年的经验。
Endoscopy. 2022 Jul;54(7):663-670. doi: 10.1055/a-1640-3236. Epub 2021 Oct 28.
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White light and/or magnifying endoscopy with narrow band imaging for superficial nonampullary duodenal epithelial tumors.
白光和/或窄带成像放大内镜用于浅表非壶腹十二指肠上皮肿瘤
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Simple scoring system for the diagnosis of superficial non-ampullary duodenal epithelial tumors.用于诊断浅表非壶腹性十二指肠上皮肿瘤的简单评分系统。
Dig Endosc. 2021 Mar;33(3):399-407. doi: 10.1111/den.13762. Epub 2020 Aug 28.
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How I do it: Endoscopic diagnosis for superficial non-ampullary duodenal epithelial tumors.方法:内镜诊断非壶腹周围浅层十二指肠上皮性肿瘤。
Dig Endosc. 2020 Mar;32(3):417-424. doi: 10.1111/den.13538. Epub 2019 Oct 31.
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Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumor < 20 mm.对比水下内镜黏膜切除术与传统内镜黏膜切除术治疗<20mm 非壶腹性浅层十二指肠上皮肿瘤的可行性研究。
Dig Endosc. 2020 Jul;32(5):753-760. doi: 10.1111/den.13524. Epub 2019 Oct 31.
7
Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma.术前诊断非壶腹周围浅层十二指肠腺癌的活检准确性。
Gastrointest Endosc. 2017 Aug;86(2):329-332. doi: 10.1016/j.gie.2016.12.007. Epub 2016 Dec 19.
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Method and timing of resection of superficial non-ampullary duodenal epithelial tumors.浅表性非壶腹十二指肠上皮肿瘤切除术的方法和时机。
Dig Endosc. 2014 Apr;26 Suppl 2:35-40. doi: 10.1111/den.12259.
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Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors in Japan: Multicenter case series.日本内镜诊断非壶腹浅表性十二指肠上皮肿瘤:多中心病例系列。
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Gastrointest Endosc. 2013 Sep;78(3):496-502. doi: 10.1016/j.gie.2013.03.1330. Epub 2013 May 2.