{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:32:14Z","timestamp":1784896334047,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The incidence of identified superficial non\u2010ampullary duodenal epithelial tumors (SNADETs) has been increasing with recent advances in endoscopic diagnosis. Nevertheless, the clinical features of SNADETs with malignant potential remain unclear. The aim of the present study was to clarify the clinical characteristics of high\u2010grade SNADETs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 328 SNADETs that had been endoscopically or surgically resected between January 2013 and April 2019 were identified from an endoscopic and pathological database. Clinical characteristics were compared between mucosal low\u2010grade neoplasm (<jats:italic>n<\/jats:italic>\u00a0=\u00a0154) and mucosal high\u2010grade neoplasm\/submucosal carcinoma (HGN\/SMC, <jats:italic>n<\/jats:italic>\u00a0=\u00a0174).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In univariate analysis, tumor size, pre\u2010ampullary tumor location, red color, and rough\/nodular surface were significantly associated with HGN\/SMC. In multivariate analysis (odds ratio [95% confidence interval]), large (\u226510\u00a0mm) tumor size (odds ratio: 4.5, 95% confidence interval: 2.6\u20137.7, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and pre\u2010ampullary tumor location (odds ratio: 2.1, 95% confidence interval: 1.3\u20133.5, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004) were independent predictors for HGN\/SMC. Analysis of histological phenotypes revealed that the proportion of tumors that were HGN\/SMC was much greater for gastric\u2010type tumors (21\/23 lesions, 91%) than for intestinal\u2010type tumors (150\/302 lesions, 50%) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and that all gastric\u2010type tumors were located in the pre\u2010ampullary portion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pre\u2010ampullary location and large tumor size are independent predictors for HGN\/SMC SNADETs. Pre\u2010ampullary tumor location is significantly associated with gastric histological phenotype. These findings may help in decision making for endoscopic treatment, active indication for pre\u2010ampullary tumor or tumor \u226510\u00a0mm, and understanding the pathophysiology of SNADETs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15317","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T20:13:41Z","timestamp":1604088821000},"page":"1605-1613","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pre\u2010ampullary location and size \u226510\u00a0mm are independent predictors for high\u2010grade superficial non\u2010ampullary duodenal epithelial tumors"],"prefix":"10.1111","volume":"36","author":[{"given":"Katsunori","family":"Matsueda","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriya","family":"Uedo","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology and Cytology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Iwagami","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoki","family":"Shichijo","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Maekawa","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kanesaka","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Higashino","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryu","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/den.12277","article-title":"Endoscopic diagnosis of superficial non\u2010ampullary duodenal epithelial tumors in Japan: multicenter case series","volume":"26","author":"Goda K","year":"2014","journal-title":"Dig. 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