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 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.

journal_name

Sci Rep

journal_title

Scientific reports

authors

Yamamoto K,Itoi T,Nagata N,Sofuni A,Tsuchiya T,Ishii K,Tanaka R,Tonozuka R,Honjo M,Mukai S,Asai Y,Matsunami Y,Yamaguchi H,Matsubayashi J,Joyama E,Nagakawa Y

doi

10.1038/s41598-020-79836-4

subject

Has Abstract

pub_date

2021-01-12 00:00:00

pages

600

issue

1

issn

2045-2322

pii

10.1038/s41598-020-79836-4

journal_volume

11

pub_type

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