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Risk factors,prognostic factors,and nomograms for distant metastasis in patients with diagnosed duodenal cancer:A population-based study

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1384-1420页

作者： Jia-Rong Shang Chen-Yi Xu Xiao-Xue Zhai Zhe Xu Jun Qian Department of Oncology Jiangsu Province Hospital of Chinese MedicineThe Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210000Jiangsu ProvinceChina Department of Proctology Nanjing Hospital of Chinese MedicineNanjing 210000Jiangsu ProvinceChina Department of Digestive cancer Surgery Jiangsu Province Hospital of Chinese MedicineThe Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210000Jiangsu ProvinceChina

BACKGROUND duodenal cancer is one of the most common subtypes of small intestinal cancer,and distant metastasis(DM)in this type of cancer still leads to poor *** nomograms have recently been used in tumor areas,no studies have focused on the diagnostic and prognostic evaluation of DM in patients with primary duodenal *** To develop and evaluate nomograms for predicting the risk of DM and person-alized prognosis in patients with duodenal *** Data on duodenal cancer patients diagnosed between 2010 and 2019 were extracted from the Surveillance,Epidemiology,and End Results *** and multivariate logistic regression analyses were used to identify independent risk factors for DM in patients with duodenal cancer,and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors in duodenal cancer patients with *** novel nomograms were established,and the results were evaluated by receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS A total of 2603 patients with duodenal cancer were included,of whom 457 cases(17.56%)had DM at the time of *** analysis revealed independent risk factors for DM in duodenal cancer patients,including gender,grade,tumor size,T stage,and N stage(Pduodenal cancer patients with DM,including age,histological type,T stage,tumor grade,tumor size,bone metastasis,chemotherapy,and surgery(Pduodenal *** The two nomograms are expected as effective tools fo

关键词： duodenal cancer Distant metastasis Nomogram Risk factors Prognostic factors

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Ampullary cancer of intestinal origin and duodenal cancer-A logical clinical and therapeutic subgroup in periampullary cancer

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World Journal of Gastrointestinal Oncology 2017年第10期9卷 407-415页

作者： Manju D Chandrasegaram Anthony J Gill Jas Samra Tim Price John Chen Jonathan Fawcett Neil D Merrett the Prince Charles Hospital School of Medicine University of Queensland Sydney Medical School University of Sydney cancer Diagnosis and Pathology Group Kolling Institute of Medical Research Royal North Shore Hospital Department of Surgery Royal North Shore Hospital Queen Elizabeth Hospital University of Adelaide Flinders Medical Centre Royal Adelaide Hospital Princess Alexandra Hospital Department of Upper GI Surgery Bankstown Hospital Discipline of Surgery Western Sydney University

Periampullary cancers include pancreatic, ampullary, biliary and duodenal cancers. At presentation, the majority of periampullary tumours have grown to involve the pancreas, bile duct, ampulla and duodenum. This can result in difficulty in defining the primary site of origin in all but the smallest tumors due to anatomical proximity and architectural distortion. This has led to variation in the reported proportions of resected periampullary cancers. Pancreatic cancer is the most common cancer resected with a pancreaticoduodenectomy followed by ampullary(16%-50%), bile duct(5%-39%), and duodenal cancer(3%-17%). Patients with resected duodenal and ampullary cancers have a better reported median survival(29-47 mo and 22-54 mo) compared to pancreatic cancer(13-19 mo). The poorer survival with pancreatic cancer relates to differences in tumour characteristics such as a higher incidence of nodal, neural and vascular invasion. While small ampullary cancers can present early with biliary obstruction, pancreatic cancers need to reach a certain size before biliary obstruction ensues. This larger size at presentation contributes to a higher incidence of resection margin involvement in pancreatic cancer. Ampullary cancers can be subdivided into intestinal or pancreatobiliary subtype cancers with histomolecular staining. This avoids relying on histomorphology alone, as even some poorly differentiated cancers preserve the histomolecular profile of their mucosa of origin. Histomolecular profiling is superior to anatomic location in prognosticating survival. Ampullary cancers of intestinal subtype and duodenal cancers are similar in their intestinal origin and form a logical clinical and therapeutic subgroup of periampullary cancers. They respond to 5-FU based chemotherapeutic regimens such as capecitabine-oxaliplatin. Unlike pancreatic cancers, KRAS mutation occurs in only approximately a third of ampullary and duodenal cancers. Future clinical trials should group ampullary cancer

关键词： Periampullary cancer Pancreatobiliary subtype Intestinal subtype Ampullary cancer duodenal cancer Epidermal growth factor receptor Pancreatic cancer Chemotherapy Pancreaticoduodenectomy KRAS

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HER2-positive adenocarcinoma arising from heterotopic pancreas tissue in the duodenum:A case report

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World Journal of Gastroenterology 2021年第28期27卷 4738-4745页

作者： Yoshifumi S Hirokawa Takashi Iwata Yoshinaga Okugawa Koji Tanaka Hiroyuki Sakurai Masatoshi Watanabe Department of Oncologic Pathology Mie University Graduate School of MedicineMie 5148507Japan cancer Center Aichi Medical UniversityAichi 4801195Japan Department of Genomic Medicine Mie University HospitalMie 5148507Japan Department of Surgery IGA City General HospitalMie 5180823Japan Hepato-biliary-pancreatic and Transplant Surgery Mie University HospitalMie 5148507Japan

BACKGROUND Adenocarcinoma originating from heterotopic pancreas tissue is a rare ***,to our knowledge,no HER2-positive cases in the duodenum have been reported in the scientific literature nor has the efficacy of trastuzumab treatment for the disease been *** SUMMARY A 65-year-old woman whose clinical diagnosis was unresectable advanced duodenal cancer with HER2 overexpression responded well to trastuzumab *** main tumor in the duodenum reduced *** patient underwent pancreaticoduodenectomy and lymph node dissection.A small number of cancer cells remained in the submucosal layer of the duodenum and pancreas *** histological and immunohistochemical examination,the patient was diagnosed with duodenal adenocarcinoma originating from heterotopic pancreas *** Trastuzumab treatment is effective in HER2-positive adenocarcinoma originating from heterotopic pancreas tissue in the duodenum.

关键词： Heterotopic pancreas tissue duodenal cancer Human epidermal growth factor receptor 2 Trastuzumab Conversion surgery Case report

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Epithelial turnover in duodenal familial adenomatous polyposis: A possible role for estrogen receptors?

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World Journal of Gastroenterology 2016年第11期22卷 3202-3211页

作者： Alfredo Di Leo Gabriella Nesi Mariabeatrice Principi Domenico Piscitelli Bruna Girardi Maria Pricci Giuseppe Losurdo Andrea Iannone Enzo Ierardi Francesco Tonelli Gastroenterology Section Department of Emergency and Organ TransplantationUniversity of Bari Pathology Section Department of Surgery and Translational MedicineUniversity of Florence Pathology Section Department of Emergency and Organ TransplantationUniversity of Bari General Surgery Section Department of Surgery and Translational MedicineUniversity of Florence

AIM: To investigate estrogen receptors expression in duodenal familial adenomatous polyposis (FAP) and any relationship with epithelial proliferation/apoptosis ***: Twenty-two patients affected by FAP undergoing duodenal resection for malignancies were recruited. Controls were 15 healthy subjects undergoing endoscopy for dyspeptic symptoms. ER-α, ER-α, Ki-67, TUNEL and caspase 3 expression (labeling index: percentage of positive cells) were evaluated by immunohistochemistry or immunofluorescence and examined by light or confocal microscopy. Samples were assigned to four groups: normal tissue, low (LGD) and high-grade dysplasia (HGD), adenocarcinoma (AC). One-way analysis of variance, corrected by Bonferroni’s test, and Pearson’s correlation test were applied for statistical ***: ER-beta showed a progressive decline: normal tissue (23.5 ± 4.9), LGD (21.1 ± 4.8), HGD (9.3 ± 3.5), AC (7.1 ± 3.1). The normal tissue of FAP subjects expressed ER-beta like the controls (23.9 ± 6.2). Conversely, ER-α showed a progressive increase from normal tissue (24.8 ± 5.6) to AC (52.0 ± 8.2); the expression in normal tissue was similar to controls (22.5 ± 5.3). Ki67 demonstrated a statistically significant progressive increase at each disease stage up to AC. TUNEL did not reveal differences between controls and normal tissue of FAP subjects, but progressive decreases were observed in LGD, through HGD to AC. Pearson’s correlation test showed a direct relationship between ER-β and TUNEL LI (r = 0.8088, P duodenal FAP carcinomas, declining in a multiple

关键词： Familial adenomatous polyposis duodenal cancer Estrogen receptors Immunohistochemistry Confocal microscopy Dysplasia

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Treatment for superficial non-ampullary duodenal epithelial tumors

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World Journal of Gastroenterology 2014年第35期20卷 12501-12508页

作者： Naomi Kakushima Hideyuki Kanemoto Masaki Tanaka Kohei Takizawa Hiroyuki Ono Division of Endoscopy Shizuoka Cancer Center Division of Hepato-Biliary-Pancreatic Surgery Shizuoka Cancer CenterShizuoka Cancer Center

Because of the low prevalence of non-ampullary duodenal epithelial tumors(NADETs),standardized clinical management of sporadic superficial NADETs,including diagnosis,treatment,and follow-up,has not yet been *** studies have revealed certain endoscopic findings suggestive of *** adenoma with high-grade dysplasia and mucosal cancer are candidates for local resection by endoscopic or minimally invasive *** use of endoscopic treatment including endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD),for the treatment for superficial NADETs is *** requires multiple sessions to achieve complete remission and repetitive endoscopy is needed after *** provides an excellent complete resection rate,however it remains a challenging method,considering the high risk of intraoperative or delayed *** invasive surgery such as wedge resection and pancreas-sparing duodenectomy are beneficial for superficial NADETs that are technically difficult to remove by endoscopic *** remains a standard surgical procedure for treatment of duodenal cancer with submucosal invasion,which presents a risk of lymph node *** or surgical treatment outcomes of superficial NADETs without submucosal invasion are *** an endoscopic diagnostic tool to differentiate superficial NADETs between adenoma and cancer as well as between mucosal and submucosal cancer is required to select the most appropriate treatment.

关键词： duodenal neoplasms duodenal cancer Pancreaticoduodenectomy Endoscopic surgery Esophagogastroduodenoscopy

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MUTYH-associated polyposis: Is it time to change upper gastrointestinal surveillance? A single-center case series and a literature overview

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World Journal of Gastrointestinal Oncology 2023年第11期15卷 1891-1899页

作者： Lupe Sanchez-Mete Lorenzo Mosciatti Marco Casadio Luigi Vittori Aline Martayan Vittoria Stigliano Gastroenterology and Digestive Endoscopy Regina Elena National Cancer InstituteIRCCSRome 00144Italy Department of Radiological Oncological and Pathological SciencesRegina Elena National Cancer InstituteIRCCSRome 00144Italy

BACKGROUND The presence of Spigelman stage(SS)IV duodenal polyposis is considered the most significant risk factor for duodenal cancer in patients with MUTYH-associated polyposis(MAP).However,advanced SS disease is rarely reported in MAP patients,and no clear recommendations on small bowel(SB)surveillance have been proposed in this patient *** To research more because that case reports of duodenal cancers in MAP suggest that they may develop in the absence of advanced benign SS disease and often involve the distal portion of the *** We describe a series of MAP patients followed up at the Regina Elena National cancer Institute of Rome(Italy).A literature overview on previously reported SB cancers in MAP is also *** We identified two(6%)SB adenocarcinomas with no previous history of duodenal *** observations,supported by literature evidence,suggest that the formula for staging duodenal polyposis and predicting risk factors for distal duodenum and jejunal cancer may need to be adjusted to take this into account rather than focusing solely on the presence or absence of SS IV *** Tip:Case reports of duodenal cancers in MUTYH-associated polyposis suggest that they may develop in the absence of advanced Spigelman stage(SS)benign disease and often involve the distal portion of the *** our case series,we identified two(6%)small-bowel adenocarcinomas with no previous history of duodenal *** observations,supported by literature evidence,suggest that the formula for staging duodenal polyposis and predicting risk factors for distal duodenum and jejunal cancer should be adjusted to take into consideration the presence of SS IV disease,rather than focusing only on this *** of invasive adenocarcinoma.

关键词： MUTYH-associated polyposis duodenal adenomatosis duodenal cancer Endoscopic management Case report

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Cystic metastasis from a mucinous adenocarcinoma of duodenum mimicking type Ⅱ choledochal cyst: A case report

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World Journal of Gastrointestinal Oncology 2017年第12期9卷 492-496页

作者： Yo Na Kim Ji Soo Song Department of Pathology Chonbuk National University Medical School Research Institute for Endocrine Sciences Department of Radiology Chonbuk National University Medical School and Hospital Research Institute of Clinical Medicine of Chonbuk National University Biomedical Research Institute of Chonbuk National University Hospital

A 51-year-old male patient was referred to our hospital because of an incidentally detected cystic mass near the common bile duct(CBD). Imaging studies demonstrated a cystic mass that was suspected to communicate with the CBD. Gastroscopy showed irregular mucosal thickening with hyperemic change in the second portion of the duodenum. A type Ⅱ choledochal cyst combined with duodenal malignancy was suspected. The patient underwent surgical resection and the histological diagnosis was mucinous adenocarcinoma of the duodenum with cystic metastasis. Although its incidence is extremely rare, care should be taken to check for other sites of malignancy when a pericholedochal cystic mass is detected.

关键词： duodenal cancer Choledochal cyst Cystic metastasis Mucinous adenocarcinoma

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A small depressed early cancer of the second portion of duodenum: report of a case and review of Japanese literature

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中华医学杂志(英文版) 1996年第10期109卷 813-813页

作者： Ken Tanigawa Kozo Akino Yoshifumi Kajiwara Kazuyuki Ozeki Takashi Kanematsu Hidenori Shibata Shunichi Yamashita Department of Preventive Medicine Atomic Disease Institute Nagasaki University School of Medicine 1-12-4 Sakamoto Nagasaki 852 Japan Second Department of Surgery Nagasaki University School of Medicine 1-12-4 Sakamoto Nagasaki 852 Japan Internal Medicine Shibata Chohkohdoh Hospital 68 Nakahori Shimabara 856 Japan

Adenocarcinoma of the duodenum is an extremely uncommon malignant process. The 5-year survival rate for patients with resectable tumor is lower than 30%. Patients with depressed duodenal cancer of the second portion in the early stage have rarely been reported. In the causes of the development of colorectal cancer, there are two hypotheses existing: the adenoma-carcinoma sequence and de novo carcinogenesis. A small ulcerated cancer without adenomatous component is thought to represent de novo cancer and easily invade the submucosal layer. We encountered a patient with a small ulcerated duodenal cancer being well demonstrated endoscopically using dye spray method with indigo carmine preoperatively, which might have been overlooked in the past. Here we report this case and also review in the Japanese literature the depressed duodenal cancer of the second portion in the early stage.

关键词： Ulcer Packaging Case duodenal cancer Adenocarcinoma of Duodenum Patients

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