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Clinicopathological characteristics of non‐ampullary duodenal tumors and their phenotypic classification
Author(s) -
Yoshida Masao,
Shimoda Tadakazu,
Abe Masato,
Kakushima Naomi,
Kawata Noboru,
Takizawa Kohei,
Ono Hiroyuki,
Sugino Takashi
Publication year - 2019
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12829
Subject(s) - major duodenal papilla , pathology , gastroenterology , phenotype , medicine , cancer , mucin , odds ratio , immunohistochemistry , intestinal cancer , colorectal cancer , biology , biochemistry , gene
The tumorigenesis of non‐ampullary duodenal epithelial tumors (NADETs) might be different between the oral and anal sides of Vater's papilla. We conducted an immunohistological review to elucidate the clinicopathological features according to the tumor location and phenotypic classification. A review of an institutional database identified 121 patients with 125 superficial NADETs. NADETs were histologically evaluated and classified into the intestinal or gastric type based on immunohistochemical analysis. Clinicopathological factors were compared based on the tumor location and phenotype. Logistic regression analysis was performed to identify independent predictors for gastric‐type NADETs. According to location analysis, the mucin phenotype was significantly different (oral side, intestinal‐type 64.8%, gastric‐type 35.3%; anal side, intestinal‐type 87.3%, gastric‐type 12.7%; P < 0.01). Although the incidence of adenoma was significantly predominant in the intestinal type (75.3%), most gastric‐type NADETs were cancerous (64.3%). Notably, most gastric‐type NADETs were adenocarcinomas even when the tumor size was ≤0 mm. In multivariate analysis, tumor location on the oral side (odds ratio [OR], 4.42), villous structure (OR, 6.44), and low tumor gland density (OR, 9.49) were independent predictors of gastric‐type tumors. Gastric‐type NADETs significantly differ from intestinal‐type NADETs in terms of tumor location, morphology, and biology.