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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(01): E58-E65
DOI: 10.1055/a-1293-7487
Original article

Does previous biopsy lead to cancer overdiagnosis of superficial non-ampullary duodenal epithelial tumors?

Shigetsugu Tsuji
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Hisashi Doyama
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Sho Tsuyama
2   Department of Human Pathology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
,
Akihiro Dejima
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Takashi Nakashima
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Shigenori Wakita
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Yosuke Kito
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Hiroyoshi Nakanishi
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Naohiro Yoshida
1   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Kazuyoshi Katayanagi
3   Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Hiroshi Minato
3   Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Takashi Yao
2   Department of Human Pathology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
,
Kenshi Yao
4   Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
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Abstract

Background and study aims We aimed to evaluate the diagnostic performance of magnifying endoscopy with narrow-band imaging (M-NBI) in superficial non-ampullary duodenal epithelial tumors (SNADETs) regarding the absence or presence of biopsy before M-NBI diagnosis.

Patients and methods Clinicopathological data were retrospectively reviewed for 99 SNADETs from 99 patients who underwent endoscopic resection. The 99 tumors were divided into the non-biopsy group (32 lesions not undergoing biopsy before M-NBI examination) and the biopsy group (67 lesions undergoing biopsy before M-NBI examination). We investigated the correlation between the M-NBI diagnosis and the histopathological diagnosis of the SNADETs in both groups.

Results According to the modified revised Vienna classification, 31 tumors were classified as category 3 (C3) (low-grade adenoma) and 68 as category 4/5 (C4/5) (high-grade adenoma/cancer). The accuracy, sensitivity, and specificity of preoperative M-NBI diagnoses in the non-biopsy group vs the biopsy group were 88 % (95 % confidence interval: 71.0 – 96.5) vs 66 % (51.5 – 75.5), P = 0.02; 95 % (77.2 – 99.9) vs 89 % (76.4 – 96.4), P = 0.39; and 70 % (34.8 – 93.3) vs 14 % (3.0 – 36.3), P < 0.01, respectively. Notably, in the biopsy group, the specificity of M-NBI in SNADETs was low at only 14 % because we over-diagnosed most C3 lesions as C4/5. M-NBI findings might have been compromised by the previous biopsy procedure itself.

Conclusions In the non-biopsy group, the accuracy of M-NBI in SNADETs was excellent in distinguishing C4/5 lesions from C3. The M-NBI findings in SNADETs should be evaluated while carefully considering the influence of a previous biopsy.



Publication History

Received: 19 July 2020

Accepted: 28 September 2020

Article published online:
01 January 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Refers to:

Stop taking routine biopsy specimens for the diagnose of a duodenal adenoma!Endosc Int Open 2021; 09(03): E470-E471
DOI: 10.1055/a-1339-1089

 

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