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Fifty-seven patients with AC who underwent curative resection were retrospectively reviewed. The 0\/IA stages were significantly more common in the intestinal type (I-type) than in the mixed and pancreatobiliary type (M&amp;PB-type) (90.7% vs 35.7%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Tis\/T1a tumors limited to the ampulla [Tis\/T1a(ampulla)] were significantly more likely to be I-type than M&amp;PB-type (74.4% vs 14.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.002). The tub1 rate was significantly higher in the I-type than in the M&amp;PB-type (81.4% vs 35.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.001). In the I-type, the tub1 rate was significantly higher for Tis\/T1a(ampulla) than for T1a tumors limited to the sphincter of Oddi (100% vs 42.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.004). These observations suggest that I-type AC with tub1 is an indication for EP. The concordance rate of pathological subtypes between endoscopic biopsy and resected specimens was high (\u03ba\u2009=\u20090.8053, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Tis\/T1a(ampulla) showed no lymphovascular or perineural invasion. An endoscopic imaging finding of early AC with I-type and tub1 on biopsy could be an indication for EP. Identifying the pathological subtype of AC by endoscopic biopsy could be a novel preoperative approach for evaluating the indications for EP.<\/jats:p>","DOI":"10.1038\/s41598-020-79836-4","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T19:24:12Z","timestamp":1610479452000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Novel method for evaluating the indication for endoscopic papillectomy in patients with ampullary adenocarcinoma"],"prefix":"10.1038","volume":"11","author":[{"given":"Kenjiro","family":"Yamamoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takao","family":"Itoi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoyoshi","family":"Nagata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Sofuni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayoshi","family":"Tsuchiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reina","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Tonozuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuyoshi","family":"Honjo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuntaro","family":"Mukai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutsugu","family":"Asai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukitoshi","family":"Matsunami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Matsubayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eri","family":"Joyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Nagakawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"79836_CR1","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1016\/j.gie.2007.02.049","volume":"66","author":"SM Yoon","year":"2007","unstructured":"Yoon, S. 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