Abstract:
BACKGROUND/GOALS:The endoscopic treatment of ampullary adenomas is established; however, the false-negative rate of endoscopic biopsy for carcinoma is 20% to 30%, and it remains uncertain whether identifiable features predict malignancy. Our aim in this study was to evaluate the predictable factors of malignancy in ampullary adenomas on endoscopic biopsy. STUDY:Ninety-one subjects diagnosed with ampullary adenoma on endoscopic biopsy were confirmed after endoscopic or surgical resection of ampullary lesions between 1995 and 2011 respectively. Clinical, laboratory, radiologic, and endoscopic findings were compared between patients with adenoma and carcinoma after resection. We examined the predictors of malignancy in ampullary adenoma on endoscopic biopsy. RESULTS:The malignancy rate in ampullary adenomas on endoscopic biopsy was 26.4%. Univariate analysis revealed that presence of symptoms, villous components, high-grade dysplasia (HGD), papilla enlargement on computed tomography, duct dilatation on radiologic imaging, bilirubin>2 mg/dL, aspartate aminotransferase>40 IU/L, alanine aminotransferase>40 IU/L, and alkaline phosphatase>90 U/L were associated with malignancy in patients over 65 years of age. HGD [odds ratio, 6.86 (95% confidence interval, 1.58-29.79)] and ductal dilatation [odds ratio, 11.12 (95% confidence interval, 2.27-54.37)] were independently associated with malignancy in multivariate analysis. The sensitivity and negative predictive value for ≥1 risk factors were 95.83% and 96.77%, respectively. The presence of 2 risk factors resulted in a high specificity (96%) and positive predictive value (84%) for malignancy. CONCLUSIONS:HGD and ductal dilatation are significant predictors of malignancy in ampullary adenomas. When these risk factors are present, precautions should be taken in the consideration of malignancy in patients with ampullary adenoma.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Kim HN,Kim KM,Shin JU,Lee JK,Lee KT,Lee KH,Kim KM,Lim JHdoi
10.1097/MCG.0b013e318272f2efsubject
Has Abstractpub_date
2013-04-01 00:00:00pages
346-51issue
4eissn
0192-0790issn
1539-2031journal_volume
47pub_type
杂志文章abstract:BACKGROUND:Guidelines for chronic hepatitis C virus (HCV) management have recommended that a liver biopsy be repeated at 3-year intervals for HIV/HCV-coinfected patients and 5-year intervals for those with HCV monoinfection to assess fibrosis progression. However, it is unclear if patients are willing to repeat this pr...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318266fe70
更新日期:2013-05-01 00:00:00
abstract::Lactobacillus species are part of normal gastrointestinal flora and are an uncommon cause of bacteremia. Lactobacillus casei subsp. rhamnosus was repeatedly isolated in the blood cultures of a 43-year-old woman with ulcerative colitis. Lactobacillus spp. could be considered a potential opportunistic pathogen whenever ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200109000-00019
更新日期:2001-09-01 00:00:00
abstract::The tissue distribution of a previously identified M(r) 40 K epithelial autoantigen in ulcerative colitis was examined in situ in the fetal tissue by immunocytochemical method, using an immunoglobulin M (IgM) monoclonal antibody (7E12H12). Fetal-autopsy tissue from 9 to 19 weeks of development (11-21 gestational weeks...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199212000-00009
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND/AIM:We investigated changes in hepatitis B surface antigen (HBsAg) level and its correlation with clinical outcomes in treatment-naive chronic hepatitis B (CHB) patients undergoing entecavir therapy. PATIENTS AND METHODS:Among 51 hepatitis B e antigen (HBeAg)-positive treatment-naive CHB patients receiving ...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/MCG.0b013e3181d52946
更新日期:2010-10-01 00:00:00
abstract::Forty-two patients underwent flexible sigmoidoscopy in the radiology department. After maximal insertion of the sigmoidoscope, a supine abdominal film documented the position of the tip of the instrument. Correlation with barium enema in all patients determined the extent of visualization of the colon relative to the ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198208000-00009
更新日期:1982-08-01 00:00:00
abstract:GOALS:To evaluate the impact of age on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing percutaneous radiofrequency ablation (RFA). BACKGROUND:Whether age plays an important role in the outcomes of HCC after RFA remains controversial. STUDY:Two hundred fifty-eight consecutive treatment naive H...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31822b36cc
更新日期:2012-01-01 00:00:00
abstract:GOALS:The study aimed to compare the level and characteristics of disease-related knowledge of patients with inflammatory bowel disease (IBD) between the West and the East using an international version of a questionnaire regarding knowledge of inflammatory bowel disease (IBD-KNOW). BACKGROUND:The authors recently dev...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001283
更新日期:2020-09-01 00:00:00
abstract::To assess the effects of the mucoprotective drug sofalcone, which has direct and indirect effects on Helicobacter pylori in vitro, the eradication rate, adverse effects, and the quality of healing peptic ulcers were evaluated. Each study patient was given 500 mg t.i.d. amoxicillin and 200 mg t.i.d. clarithromycin. In ...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-199800001-00031
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Inactive and active phases of hepatitis B e antigen-negative chronic hepatitis B virus (HBV) infection are diagnosed by serum HBV DNA levels, with cutoff at 2000 IU/mL. However, it is difficult to distinguish inactive carriers at a single time point because HBV DNA levels can transiently decrease to <2000 IU...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3182a4711d
更新日期:2014-02-01 00:00:00
abstract::In four of five patients with gastric cancer who also had a chronic duodenal ulcer, the histologic type was "early gastric cancer," which offers a better prognosis than the more common type. Patients with duodenal ulcer who develop gastric cancer may have a better prognosis than patients with gastric cancer without du...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198702000-00009
更新日期:1987-02-01 00:00:00
abstract::Jejunal varices were a cause of recurrent gastrointestinal hemorrhage in an 18-year-old man with common variable immunodeficiency and nodular lymphoid hyperplasia of the small intestine. Despite numerous procedures, including upper gastrointestinal endoscopy, colonoscopy, arteriography, and exploratory laparotomy no a...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198510000-00010
更新日期:1985-10-01 00:00:00
abstract::Meal period exclusion from 24-h pH testing allows better separation between controls and patients with gastroesophageal reflux disease. We reviewed the results of 24-h pH studies of 350 patients with reflux symptoms. They were divided into two groups based on the 95th percentile of the total percentage of time when pH...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199707000-00003
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:The aims of this study were to analyze the overall survival of patients with cirrhosis and small hepatocellular carcinoma (HCC) and identify independent pretreatment predictors of survival in Brazil. METHODS:Between 1998 and 2003, 74 patients with cirrhosis and small HCC were evaluated. Predictors of surviv...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31817ff199
更新日期:2009-02-01 00:00:00
abstract:GOALS:To investigate the association between treatment nonadherence and patients' knowledge of the prescribed medication among individuals with inflammatory bowel disease (IBD), and evaluate the impact of nonadherence on relapse. BACKGROUND:The patient's knowledge of the prescribed medication has been identified as an...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000431
更新日期:2016-02-01 00:00:00
abstract::Among the factors involved in the pathogenesis of gastric ulcer, the reduced clearing capacity of the stomach seems to play an important role. On this basis, cisapride, which improves gastrointestinal motility, enhances gastric emptying, and prevents duodenogastric reflux, may be effective in the treatment of the gast...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-199307000-00003
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:To determine serum nitric oxide levels in pediatric patients with celiac disease and to compare them with the results obtained after 1 year of gluten-free diet. METHODS:We studied serum nitric oxide levels in 41 newly diagnosed patients with celiac disease. Serum levels of nitric oxide were reevaluated afte...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000177240.67215.da
更新日期:2005-10-01 00:00:00
abstract:GOALS:To describe the association of untreated celiac disease with hyperhomocysteinemia and variants of the methylenetetrahydrofolicacid reductase (MTHFR) gene found in clinical practice. STUDY:Case studies with description of associated clinical, biochemical, and genetic findings and review of literature. RESULTS:Fi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200608000-00007
更新日期:2006-08-01 00:00:00
abstract::Dietary intake and plasma lipids were estimated in 200 patients with gallstones and 98 control subjects from a hospital in Northern India and were matched for age, sex, and social class. The intake of total calories and carbohydrates and the plasma triglyceride values were higher in all gallstone patients as compared ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199601000-00007
更新日期:1996-01-01 00:00:00
abstract::We assessed bowel sounds in controls and patients with acute abdominal conditions using a new computer-aided sound analysis system (C.A.S.A.S.). Sixty-three controls and 61 patients with an acute abdomen had 10-min recordings of bowel sounds in a silent environment with computer analysis of the digitized acoustic sign...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:GOAL:The goal of this study is to determine factors associated with performance of duodenal biopsy during upper endoscopy. BACKGROUND:Celiac disease (CD) prevalence approaches 1% in the United States and Europe, yet CD remains underdiagnosed, in part because of low rates of duodenal biopsy during upper endoscopy. We a...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000957
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The gastrointestinal safety of the novel injectable cyclooxygenase-2 selective inhibitor, parecoxib sodium, was compared with the nonselective nonsteroidal anti-inflammatory drug, ketorolac, and placebo in healthy subjects. STUDY:In a multicenter, randomized, double-blind, placebo-controlled design, 123 adu...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00004836-200408000-00007
更新日期:2004-08-01 00:00:00
abstract::A 16-year-old boy was hospitalized because of abdominal pain, diarrhea, and weight loss. Serum immunoelectrophoresis showed an absence of IgA and diminished levels of IgM and IgG. Radiological examination of the upper gut was suggestive of lymphoid nodular hyperplasia, a diagnosis confirmed by endoscopy and intestinal...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198006000-00012
更新日期:1980-06-01 00:00:00
abstract::We describe an adenocarcinoma of the jejunum that developed in congenital heterotopic gastric mucosa, a rare event. In our patient, the absence of other intestinal malformation and the presence of gastric glands with variable grades of dysplasia, together with the histological pattern of the tumor, strongly favor the ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198802000-00020
更新日期:1988-02-01 00:00:00
abstract:GOALS:A clinical problem is posed by patients with symptoms suggestive of gluten sensitivity (diarrhea, weight loss, unresponsive iron-deficiency anemia, etc.); however, small intestinal biopsies reveal only minor abnormalities, such as lymphocytosis with or without crypt hyperplasia (Marsh I-II). Our aim was to assess...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200301000-00006
更新日期:2003-01-01 00:00:00
abstract::Pyogenic abscesses of the liver occur in association with a variety of diseases. Sometimes they are caused by anaerobic infections of liver metastases. Uncommonly, however, multiple hepatic abscesses caused by anaerobic bacteria are the presenting signs of unsuspected colonic cancer in the absence of liver metastases....
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199206000-00013
更新日期:1992-06-01 00:00:00
abstract:GOALS:Our study reexamines the prevalence of interval colorectal cancer (I-CRC) by manually reviewing CRC cases at a single institution. BACKGROUND:In 2% to 8% of patients with CRC, diagnosis occurs during the interval 6 to 36 months after a cancer-free colonoscopy. Rates are often determined by linking the date of co...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000183
更新日期:2015-07-01 00:00:00
abstract::The single technological advancement that Bravo pH monitoring offers over conventional pH monitoring is the elimination of the transnasal catheter. This was not a trivial advance in terms of technologic achievement. Development of a delivery system that could temporarily place a wireless capsule on the esophageal muco...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e31815bb602
更新日期:2008-05-01 00:00:00
abstract::Twenty consecutive patients with first-time presentation of suspected inflammatory bowel disease underwent both endoscopy with biopsy and magnetic resonance imaging (MRI) within a 3-day period; the relative abilities of endoscopy and MRI to distinguish ulcerative colitis (UC) from Crohn's disease (CD) and to determine...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-199407000-00009
更新日期:1994-07-01 00:00:00
abstract::Radiation therapy directed at the abdomen may damage the digestive tract, the type and extent of injury depending on the dose of the radiation and the radiation sensitivity of the gut. Characteristic early changes are manifest in the mucosa of the gut: for later ulceration, changes in the collagen tissues and particul...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-197903000-00003
更新日期:1979-03-01 00:00:00
abstract::We reviewed the initial lipid and fat-soluble vitamin levels in 56 patients with primary sclerosing cholangitis (PSC) enrolled in a randomized, placebo-controlled trial evaluating ursodeoxycholic acid. We also evaluated lipid and vitamin levels in a group of 87 patients with advanced PSC being evaluated for liver tran...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-199504000-00011
更新日期:1995-04-01 00:00:00