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Preoperative endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors, including magnifying endoscopy

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World Journal of Gastroenterology 2015年第41期21卷 11832-11841页

作者： Shigetsugu Tsuji Hisashi Doyama Kunihiro Tsuji Sho Tsuyama Kei Tominaga Naohiro Yoshida Kenichi Takemura Shinya Yamada Hideki Niwa Kazuyoshi Katayanagi hiroshi kurumaya Toshihide Okada Department of Gastroenterology Ishikawa Prefectural Central Hospital Kanazawa Department of Diagnostic Pathology Ishikawa Prefectural Central Hospital Kanazawa

Superficial non-ampullary duodenal epithelial tumor(SNADET) is defined as a sporadic tumor that is confined to the mucosa or submucosa that does not arise from Vater's papilla, and it includes adenoma a n d a d e n o c a r c i n o m a. R e c e n t d e v e l o p m e n t s i n endoscopic technology, such as high-resolution endoscopy and image-enhanced endoscopy, may increase the chances of detecting SNADET lesions. However, because SNADET is rare, little is known about its preoperative endoscopic diagnosis. The use of endoscopic resection for SNADET, which has no risk of metastasis, is increasing, but the incidence of complications, such as perforation, is significantly higher than in any other part of the digestive tract. A preoperative diagnosis is required to distinguish between lesions that should be followed up and those that require treatment. Retrospective studies have revealed certain endoscopic findings that suggest malignancy. In recent years, several new imaging modalities have been developed and explored for realtime diagnosis of these lesion types. Establishing an endoscopic diagnostic tool to differentiate between adenoma and adenocarcinoma in SNADET lesions is required to select the most appropriate treatment. This review describes the current state of knowledge about preoperative endoscopic diagnosis of SNADETs, such as duodenal adenoma and duodenal adenocarcinoma. Newer endoscopic techniques, including magnifying endoscopy, may help to guide these diagnostics, but their additional advantages remain unclear, and further studies are required to clarify these issues.

关键词： Endoscopy Duodenoscopy Duodenal neoplasms Narrow b

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