Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma

Abstract This study aimed to determine the clinicopathological features of the subtypes of ampullary carcinoma (AC) to explore the indications for endoscopic papillectomy (EP) in early AC. Fifty-seven patients with AC who underwent curative resection were retrospectively reviewed. The 0/IA stages we...

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Autores principales:	Kenjiro Yamamoto, Takao Itoi, Naoyoshi Nagata, Atsushi Sofuni, Takayoshi Tsuchiya, Kentaro Ishii, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Yasutsugu Asai, Yukitoshi Matsunami, Hiroshi Yamaguchi, Jun Matsubayashi, Eri Joyama, Yuichi Nagakawa
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/09de9eb41966453b992c78634ea0c4c5
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spelling	oai:doaj.org-article:09de9eb41966453b992c78634ea0c4c52021-12-02T14:12:09ZNovel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma10.1038/s41598-020-79836-42045-2322https://doaj.org/article/09de9eb41966453b992c78634ea0c4c52021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79836-4https://doaj.org/toc/2045-2322Abstract This study aimed to determine the clinicopathological features of the subtypes of ampullary carcinoma (AC) to explore the indications for endoscopic papillectomy (EP) in early AC. Fifty-seven patients with AC who underwent curative resection were retrospectively reviewed. The 0/IA stages were significantly more common in the intestinal type (I-type) than in the mixed and pancreatobiliary type (M&PB-type) (90.7% vs 35.7%, P < 0.001). Tis/T1a tumors limited to the ampulla [Tis/T1a(ampulla)] were significantly more likely to be I-type than M&PB-type (74.4% vs 14.3%, P = 0.002). The tub1 rate was significantly higher in the I-type than in the M&PB-type (81.4% vs 35.7%, P = 0.001). In the I-type, the tub1 rate was significantly higher for Tis/T1a(ampulla) than for T1a tumors limited to the sphincter of Oddi (100% vs 42.9%, P = 0.004). These observations suggest that I-type AC with tub1 is an indication for EP. The concordance rate of pathological subtypes between endoscopic biopsy and resected specimens was high (κ = 0.8053, P < 0.001). Tis/T1a(ampulla) showed no lymphovascular or perineural invasion. An endoscopic imaging finding of early AC with I-type and tub1 on biopsy could be an indication for EP. Identifying the pathological subtype of AC by endoscopic biopsy could be a novel preoperative approach for evaluating the indications for EP.Kenjiro YamamotoTakao ItoiNaoyoshi NagataAtsushi SofuniTakayoshi TsuchiyaKentaro IshiiReina TanakaRyosuke TonozukaMitsuyoshi HonjoShuntaro MukaiYasutsugu AsaiYukitoshi MatsunamiHiroshi YamaguchiJun MatsubayashiEri JoyamaYuichi NagakawaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kenjiro Yamamoto Takao Itoi Naoyoshi Nagata Atsushi Sofuni Takayoshi Tsuchiya Kentaro Ishii Reina Tanaka Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai Yasutsugu Asai Yukitoshi Matsunami Hiroshi Yamaguchi Jun Matsubayashi Eri Joyama Yuichi Nagakawa Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma
description	Abstract This study aimed to determine the clinicopathological features of the subtypes of ampullary carcinoma (AC) to explore the indications for endoscopic papillectomy (EP) in early AC. Fifty-seven patients with AC who underwent curative resection were retrospectively reviewed. The 0/IA stages were significantly more common in the intestinal type (I-type) than in the mixed and pancreatobiliary type (M&PB-type) (90.7% vs 35.7%, P < 0.001). Tis/T1a tumors limited to the ampulla [Tis/T1a(ampulla)] were significantly more likely to be I-type than M&PB-type (74.4% vs 14.3%, P = 0.002). The tub1 rate was significantly higher in the I-type than in the M&PB-type (81.4% vs 35.7%, P = 0.001). In the I-type, the tub1 rate was significantly higher for Tis/T1a(ampulla) than for T1a tumors limited to the sphincter of Oddi (100% vs 42.9%, P = 0.004). These observations suggest that I-type AC with tub1 is an indication for EP. The concordance rate of pathological subtypes between endoscopic biopsy and resected specimens was high (κ = 0.8053, P < 0.001). Tis/T1a(ampulla) showed no lymphovascular or perineural invasion. An endoscopic imaging finding of early AC with I-type and tub1 on biopsy could be an indication for EP. Identifying the pathological subtype of AC by endoscopic biopsy could be a novel preoperative approach for evaluating the indications for EP.
format	article
author	Kenjiro Yamamoto Takao Itoi Naoyoshi Nagata Atsushi Sofuni Takayoshi Tsuchiya Kentaro Ishii Reina Tanaka Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai Yasutsugu Asai Yukitoshi Matsunami Hiroshi Yamaguchi Jun Matsubayashi Eri Joyama Yuichi Nagakawa
author_facet	Kenjiro Yamamoto Takao Itoi Naoyoshi Nagata Atsushi Sofuni Takayoshi Tsuchiya Kentaro Ishii Reina Tanaka Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai Yasutsugu Asai Yukitoshi Matsunami Hiroshi Yamaguchi Jun Matsubayashi Eri Joyama Yuichi Nagakawa
author_sort	Kenjiro Yamamoto
title	Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma
title_short	Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma
title_full	Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma
title_fullStr	Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma
title_full_unstemmed	Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma
title_sort	novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/09de9eb41966453b992c78634ea0c4c5
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Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma

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