The mucin phenotype does not affect the endoscopic resection outcome of non-ampullary duodenal epithelial tumors

Yosuke Toya; Masaki Endo; Shun Yamada; Tomofumi Oizumi; Toshifumi Morishita; Risaburo Akasaka; Shunichi Yanai; Shotaro Nakamura; Makoto Eizuka; Noriyuki Uesugi; Tamotsu Sugai; Takayuki Matsumoto

doi:10.1055/a-1477-3186

The mucin phenotype does not affect the endoscopic resection outcome of non-ampullary duodenal epithelial tumors

Endosc Int Open. 2021 Aug 16;9(9):E1297-E1302. doi: 10.1055/a-1477-3186. eCollection 2021 Sep.

Authors

Affiliations

¹ Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan.
² Kaiunbashi Endoscopy Clinic, Morioka, Japan.
³ Division of Molecular Diagnostic Pathology, Department of Pathology, School of Medicine, Iwate Medical University, Yahaba, Japan.

Abstract

Background and study aims Some studies have reported an association between clinicopathological features and mucin phenotypes of non-ampullary duodenal epithelial tumors (NADETs). However, the association between clinical outcomes of endoscopic resection (ER) and mucin phenotypes has not been elucidated. The aim of this retrospective study was to analyze clinical outcomes of ER of NADETs with reference to mucin phenotypes. Patients and methods We retrospectively evaluated the clinical outcomes of ER for NADETs performed from 2006 to 2019 and compared clinicopathological characteristics, ER procedures, and outcomes, including adverse events (AEs) among tumors classified by mucin phenotype. Mucin phenotypes were classified as gastric, gastrointestinal, and intestinal based on immunohistochemical examination. Grade of dysplasia was determined according to the Vienna classification (VCL). Results The proportion of VCL 4/5 was higher in the gastric type (50 %) compared with that in the gastrointestinal (39.1 %, P = 0.009) and intestinal types (5.4 %, P = 0.008), respectively. With no statistical difference in tumor size and ER method among the three groups, no significant difference was observed for ER outcomes, i. e., en bloc and R0 resection rates. In the gastrointestinal and intestinal types, AEs occurred in four cases treated with ESD, but none developed in the gastric type. Conclusions This study suggests that the mucin phenotype does not affect resection outcome. However, considering high malignant potential and tendency for low AE rates, the gastric type NADETs may be more appropriate for proactive ER than the others.

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