ArticleJournal of gastroenterology2022
Differential diagnosis of superficial duodenal epithelial tumor and non-neoplastic lesion in duodenum by magnified endoscopic examination with image-enhanced endoscopy.
Article in Journal of gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 16 citations in OpenAlex.
- Mucin phenotype stratifies histological malignancy in superficial non-ampullary duodenal epithelial tumors: a prospective study.Journal of gastroenterology · 2026Article
- Article
- Diagnostic performance of indigo carmine-assisted texture and color enhanced magnified imaging for superficial non-ampullary duodenal epithelial tumors.Therapeutic advances in gastroenterology · 2026Article
- Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients.DEN open · 2025Article
- Pathological diagnosis and clinical feature analysis of descending duodenal mucosal adenocarcinoma: A case report.World journal of gastrointestinal surgery · 2024Article
- Article
- Misidentification of a duodenal neuroendocrine tumor as an adenoma, with subsequent attempted resection by cold snare polypectomy.Endoscopy · 2023Article
- Duodenal gastric-type neoplasm with uncertain malignant potential in a lipoma.Clinical journal of gastroenterology · 2023Article
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferential diagnosis of superficial duodenal epithelial tumors (SDETs) and non-neoplastic lesions (NNLs) in duodenum by endoscopy is difficult. Here, we attempted to distinguish them by magnified endoscopic examination with image-enhanced endoscopy (IEE-ME).
methodsVarious IEE-ME findings of 95 SDETs who underwent endoscopic resection and 58 NNLs who underwent biopsy were retrospectively reviewed.
resultsWhen we compared the IEE-ME findings of SDETs and NNLs, the presence of demarcation line (DL) (97.9% vs. 79.3%, P = 0.0002), white opaque substance (WOS) (84.2% vs. 1.7%, P < 0.0001) and light blue crest (LBC) (93.7% vs. 32.8%, P < 0.0001) and the absence of enlarged marginal epithelium (EME) (98.9% vs. 62.1%, P < 0.0001) were significantly more frequent in SDETs than NNLs. When divided into each superficial structure, it was the most effective to evaluate the combination of WOS and LBC as SDET with open-loop structure (OLS), and the combination of DL and EME as SDET with closed-loop structure (CLS). However, LBC was excluded because of low inter- and intra-observer agreements. Finally, the sensitivity, specificity and accuracy for the diagnosis of SDETs were 88.4%, 98.3% and 92.2%, respectively, and we developed an algorithm for the differential diagnosis of duodenal lesions.
conclusionWe could distinguish SDET from NNL, diagnosed SDET as presence of WOS indicated OLS of superficial structure, and presence of DL and absence of EME indicated CLS of superficial structure.
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