Gastric Duodenal Metaplasia in Duodenal Adenomas

Overview

Journal J Clin Pathol

Specialty Pathology

Date 2006 Jul 14

PMID 16837629

Citations 6

Authors

C A Rubio

Affiliations

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Abstract

Background: In cases of known aetiology, gastric duodenal metaplasia (GMD) is a reversible lesion. In cases of unknown aetiology, the fate of GMD remains elusive. GMD was recently found in a duodenal adenoma.

Aim: To audit the frequency of GMD occurring in a cohort of duodenal adenomas.

Methods: Filed H&E-stained sections from 306 consecutive duodenal adenomas were investigated for the presence of GMD.

Results: 68% of the adenomas (n = 208) were from patients with familial adenomatous polyposis (FAP), and the remaining 32% (n = 98) were sporadic. GMD was found in 31.7% (66/208) of the duodenal FAP adenomas and in 59.2% (58/98) of the duodenal sporadic adenomas (p<0.05). The causes for this difference are elusive.

Conclusions: As for other metaplasias of the gastrointestinal tract (intestinal metaplasia of the oesophagus and of the stomach, and metaplastic-hyperplastic polyposis of the colon, known to antedate neoplastic transformation), a subset of GMDs of unknown cause might be present in the duodenal mucosa before adenomatous changes ensue. That subset of GMD might have neoplastic proclivity similar to the metaplastic epithelium in other organs of the gastrointestinal tract. The known carcinogenic effect of high concentrations of bile acids and pancreatic juices bathing the duodenal mucosa carrying an irreversible subset of GDM might set aflame the adenomatous neoplastic transformation in these patients.

Citing Articles

Duodenal Gastric Metaplasia and Duodenal Neuroendocrine Neoplasms: More Than a Simple Coincidence?.

Massironi S, Rossi R, Milanetto A, Andreasi V, Campana D, Nappo G J Clin Med. 2022; 11(9).

PMID: 35566783 PMC: 9099754. DOI: 10.3390/jcm11092658.

Endoscopic assessment and management of sporadic duodenal adenomas: The results of single centre multidisciplinary management.

Rajkomar K, Kweon M, Khan I, Frankish P, Rodgers M, Koea J World J Gastrointest Endosc. 2017; 9(4):196-203.

PMID: 28465787 PMC: 5394727. DOI: 10.4253/wjge.v9.i4.196.

Nonampullary duodenal adenoma: Current understanding of its diagnosis, pathogenesis, and clinical management.

Lim C, Cho Y World J Gastroenterol. 2016; 22(2):853-61.

PMID: 26811631 PMC: 4716083. DOI: 10.3748/wjg.v22.i2.853.

Oral benzo[a]pyrene-induced cancer: two distinct types in different target organs depend on the mouse Cyp1 genotype.

Shi Z, Dragin N, Miller M, Stringer K, Johansson E, Chen J Int J Cancer. 2010; 127(10):2334-50.

PMID: 20127859 PMC: 2917638. DOI: 10.1002/ijc.25222.

Stem cells might participate in the cell turnover of duodenal adenomas.

Rubio C Int J Clin Exp Pathol. 2008; 2(2):149-53.

PMID: 19079649 PMC: 2583632.

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