Histopathological Features Associated with Aggressive Behavior in Extra-ampullary Tetsuo Ushiku 1 , Moe Kato 1 , Sho Yamazawa 1 , Aya Shinozaki-Ushiku 1 1Department of Pathology, Graduate School of Medicine, the University of Tokyo, Tokyo Keyword: 十二指腸非乳頭部癌 , 粘液形質 , 早期癌 , ミスマッチ修復異常 pp.1095-1101
Published Date 2019/7/25
DOI https://doi.org/10.11477/mf.1403201801
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 We conducted a retrospective analysis of 36 extra-ampullary duodenal adenocarcinomas with a special focus on mucin phenotype as well as risk factors of nodal metastasis in early cancer. Tumors with gastric phenotype were located in the proximal duodenum and were more frequently detected as early cancer than those with intestinal phenotype. Gastric phenotype had a higher likelihood of being associated with aggressive phenotype in early cancer because all tumors with lymphovascular invasion(n=4), undifferentiated histology(n=1), or positive lymph nodes(n=1)exhibited gastric phenotype. The results also showed a relatively high incidence of mismatch repair deficiency, particularly in tumors with intestinal phenotype. This suggests the need for an MSI test to provide patients with optimal treatment options including a checkpoint inhibitor.

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