Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy

• 作者: Haruhiko Ogata Kaoru Takabayashi Kayoko Fukuhara Kenji JL Limpias Kamiya Makoto Naganuma Masayuki Shimoda Naoki Hosoe Ryoichi Miyanaga Seiichiro Fukuhara Shinta Mizuno Takanori Kanai Tomofumi Horie Yukie Hayashi
• 来源期刊: 世界胃肠内镜杂志:英文版(电子版)
• 学科: 医学
• 关键词: Small INTESTINE MALIGNANT Tumor Double BALLOON ENTEROSCOPY BALLOON ENTEROSCOPY Video CAPSULE ENDOSCOPY ENDOSCOPY
• 年，卷（期）: 2019,（5）
• 页码范围: 373-382
• 页数: 10页
• 分类号: R

摘要

BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy (BAE) enable visualization of rare small bowel conditions such as small intestinal malignant tumors. However, details of the endoscopic characteristics of small intestinal malignant tumors are still unknown. AIM To elucidate the endoscopic characteristics of small intestinal malignant tumors. METHODS From March 2005 to February 2017, 1329 BAE procedures were performed at Keio University Hospital. Of these procedures, malignant tumors were classified into three groups, Group 1: epithelial tumors including primary small intestinal cancer, metastatic small intestinal cancer, and direct small intestinal invasion by an adjacent organ cancer;Group 2: small intestinal malignant lymphoma;and Group 3, small intestinal gastrointestinal stromal tumors. We systematically collected clinical and endoscopic data from patients’ medical records to determine the endoscopic characteristics for each group.RESULTS The number of patients in each group was 16 (Group 1), 23 (Group 2), and 6 (Group 3), and the percentage of solitary tumors was 100%, 43.5%, and 100%, respectively (P < 0.001). Patients’ clinical background parameters including age, symptoms, and laboratory data were not significantly different between the groups. Seventy-five percent of epithelial tumors (Group 1) were located in the upper small intestine (duodenum and ileum), and approximately 70% of gastrointestinal stromal tumors (Group 3) were located in the jejunum. Solitary protruding or mass-type tumors were not seen in malignant lymphoma (Group 2)(P < 0.001). Stenosis was seen more often in Group 1,(68.8%, 27.3%, and 0%;Group 1, 2, and 3, respectively;P = 0.004). Enlarged white villi inside and/or surrounding the tumor were seen in 12.5%, 54.5%, and 0% in Group 1, 2, and 3, respectively (P = 0.001). CONCLUSION The differential diagnosis of small intestinal malignant tumors could be tentatively made based on BAE findings.