Endoscopic and biopsy diagnoses of superficial, nonampullary, duodenal adenocarcinomas

Table 1 Clinicopathological characteristics of the 74 patients (84 lesions) n (%)

Sex (male/female)	54/21
Age, yr, median (range)	64 (33-84)
Location
1st portion	12 (14)
2nd portion	68 (81)
3rd portion	4 (5)
Final lesion diameter, mm, median (range)	14.5 (2-80)
Gross type
Is, Isp, Ip	17 (20)
IIa	25 (30)
IIa + Is, IIa + IIc, Is + IIc	38 (45)
IIc	4 (5)
Biopsy histology
Non-neoplastic	2 (2)
LGA	19 (23)
HGA	7 (8)
Carcinoma	46 (55)
NA	10 (12)
Treatment
Endoscopic resection	35 (42)
Surgical resection	49 (58)
Final histology
Hyperplasia	3 (4)
LGA	10 (12)
HGA	5 (6)
Carcinoma	65 (77)
NE	1 (1)

LGA: Low-grade adenoma; HGA; High-grade adenoma; NA; Not assessed; NE: Not evaluable.

Table 2 Diagnoses of endoscopy, biopsy, and final histology after treatment n (%)

		Final histology
		Non-neoplastic	LGA	HGA	Carcinoma
Endoscopic Dx (n = 83)	Non-neoplastic	0	1 (50)	0	1 (50)
	(n = 2)
	Adenoma (n = 24)	1 (4)	8 (33)	3 (13)	12 (50)
	Carcinoma (n = 57)	2 (3.5)	1 (2)	2 (3.5)	52 (91)
Biopsy Dx(n = 73)	Non-neoplastic	0	2 (100)	0	0
	(n = 2)
	LGA (n = 19)	2 (11)	5 (26)	1 (5)	11 (58)
	HGA (n = 7)	1 (14)	0	1 (14)	5 (71)
	Carcinoma (n = 45)	0	0	3 (7)	42 (93)

Dx: Diagnosis; LGA: Low-grade adenoma; HGA: High-grade adenoma.

Table 3 Comparison of endoscopic and biopsy diagnoses with final histology

		Final histology
		Non-carcinoma	Carcinoma
Endoscopic Dx (n = 83)	Non-carcinoma (n = 26)	12	14
	Carcinoma (n = 57)	5	52
Sensitivity, 80%; Specificity, 72%; Accuracy, 78%
Biopsy Dx (n = 73)	Non-carcinoma (n = 28)	12	16
	Carcinoma (n = 45)	3	42
Sensitivity, 72%; Specificity, 80%; Accuracy, 74%

Dx: Diagnosis.

Table 4 Preoperative endoscopic factors associated with the final histology of adenoma or carcinoma

Factor		Adenoma (n = 15)	Carcinoma (n = 65)	P value1
Location, n	1st portion (n = 11)	4	7	NS
	2nd portion (n = 65)	11	54
	3rd portion (n = 4)	0	4
Preoperative diameter, mm, n	< 20 (n = 53)	13	40	0.060
	≥ 20 (n = 27)	2	25
Color, n	White or isocolor (n = 34)	12	22	0.001
	Red (n = 46)	3	43
Depressed area, n	Present (n = 40)	3	37	0.009
	Absent (n = 40)	12	28
Lobulation, n	Present (n = 42)	9	33	0.500
	Absent (n = 38)	6	32
Marginal whitening, n	Present (n = 52)	9	43	NS
	Absent (n = 28)	6	22
Gross type, n	Elevated type	13	26	0.002
	(Is, Isp, Ip, IIa) (n = 39)
	Depressed type (IIc) (n = 4)	0	4
	Mixed type (IIa + Is, IIa + IIc, Is + IIc) (n = 37)	2	35

¹χ² test. NS: Not significant.

Table 5 Multivariate logistic regression analysis of endoscopic factors indicative of duodenal carcinoma

Factor	OR	P value	95%CI
Color	2.360	0.038	1.04-5.32
Lobulation	0.553	0.389	0.14-2.13
Marginal whitening	0.546	0.359	0.15-1.98
Gross type	2.258	0.064	0.95-5.35

OR: Odds ratio.