Clinical Endoscopy

  • 제44권1호
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  • Pages.13-21
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  • 2011
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지
DOI QR코드

DOI QR Code

Current Advance in Small Bowel Tumors

  • Cheung, Dae-Young (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Choi, Myung-Gyu (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • 발행 : 2011.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

Small intestinal tumors are difficult challenge to gastroenterologists. The difficulty in making a diagnosis of small intestinal tumor lies in the relative inaccessibility and absence of typical presentation. New endoscopic and radiologic technologies provide clear and fine anatomical visualization of the small bowel and are approved to improve the diagnostic sensitivity and accuracy. Patients at risk of small intestinal tumors might gain a benefit from proper surveillance with this new technology. Minimally invasive therapy is now available with advance of balloon assisted enteroscopy. This review describes the general aspect of the small intestinal tumors, focusing on the new modalities for diagnosis.

키워드

참고문헌

  1. Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin 2002;52:23-47. https://doi.org/10.3322/canjclin.52.1.23
  2. Chow JS, Chen CC, Ahsan H, Neugut AI. A population-based study of the incidence of malignant small bowel tumours: SEER, 1973-1990. Int J Epidemiol 1996;25:722-728. https://doi.org/10.1093/ije/25.4.722
  3. Korea Central Cancer Registry, National Cancer Center. Annual Report of Cancer Statistics in Korea in 2008. Seoul: Ministry of Health and Welfare of Korea; 2010.
  4. Bilimoria KY, Bentrem DJ, Wayne JD, Ko CY, Bennett CL, Talamonti MS. Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg 2009;249:63-71. https://doi.org/10.1097/SLA.0b013e31818e4641
  5. Neugut AI, Jacobson JS, Suh S, Mukherjee R, Arber N. The epidemiology of cancer of the small bowel. Cancer Epidemiol Biomarkers Prev 1998;7:243-251.
  6. Gao C, Wang AY. Significance of increased apoptosis and Bax expression in human small intestinal adenocarcinoma. J Histochem Cytochem 2009;57:1139-1148. https://doi.org/10.1369/jhc.2009.954446
  7. Cheung DY, Lee IS, Chang DK, et al. Capsule endoscopy in small bowel tumors: a multicenter Korean study. J Gastroenterol Hepatol 2010;25:1079-1086. https://doi.org/10.1111/j.1440-1746.2010.06292.x
  8. Rondonotti E, Pennazio M, Toth E, et al. Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study. Endoscopy 2008;40:488-495. https://doi.org/10.1055/s-2007-995783
  9. O'Riordan BG, Vilor M, Herrera L. Small bowel tumors: an overview. Dig Dis 1996;14:245-257. https://doi.org/10.1159/000171556
  10. Gore RM. Small bowel cancer. Clinical and pathologic features. Radiol Clin North Am 1997;35:351-360.
  11. Ohmiya N, Yano T, Yamamoto H, et al. Diagnosis and treatment of obscure GI bleeding at double balloon endoscopy. Gastrointest Endosc 2007;66(3 Suppl):S72-S77. https://doi.org/10.1016/j.gie.2007.05.041
  12. Choi H, Choi KY, Eun CS, et al. Korean experience with double balloon endoscopy: Korean Association for the Study of Intestinal Diseases multi-center study. Gastrointest Endosc 2007;66(3 Suppl):S22-S25. https://doi.org/10.1016/j.gie.2007.06.048
  13. Hindryckx P, Botelberge T, De Vos M, De Looze D. Clinical impact of capsule endoscopy on further strategy and long-term clinical outcome in patients with obscure bleeding. Gastrointest Endosc 2008;68:98-104. https://doi.org/10.1016/j.gie.2007.09.042
  14. Hadithi M, Heine GD, Jacobs MA, van Bodegraven AA, Mulder CJ. A prospective study comparing video capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2006;101:52-57. https://doi.org/10.1111/j.1572-0241.2005.00346.x
  15. Shim KN, Kim YS, Kim KJ, et al. Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy: a Korean multicenter study. Scand J Gastroenterol 2006;41:983-988. https://doi.org/10.1080/00365520600548974
  16. Hatzaras I, Palesty JA, Abir F, et al. Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry. Arch Surg 2007;142:229-235. https://doi.org/10.1001/archsurg.142.3.229
  17. Donohue JH. Malignant tumours of the small bowel. Surg Oncol 1994;3:61-68. https://doi.org/10.1016/0960-7404(94)90001-9
  18. North JH, Pack MS. Malignant tumors of the small intestine: a review of 144 cases. Am Surg 2000;66:46-51.
  19. Schottenfeld D, Beebe-Dimmer JL, Vigneau FD. The epidemiology and pathogenesis of neoplasia in the small intestine. Ann Epidemiol 2009;19:58-69. https://doi.org/10.1016/j.annepidem.2008.10.004
  20. Qubaiah O, Devesa SS, Platz CE, Huycke MM, Dores GM. Small intestinal cancer: a population-based study of incidence and survival patterns in the United States, 1992 to 2006. Cancer Epidemiol Biomarkers Prev 2010;19:1908-1918. https://doi.org/10.1158/1055-9965.EPI-10-0328
  21. Caplin ME, Buscombe JR, Hilson AJ, Jones AL, Watkinson AF, Burroughs AK. Carcinoid tumour. Lancet 1998;352:799-805. https://doi.org/10.1016/S0140-6736(98)02286-7
  22. Modlin IM, Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer 1997;79:813-829.
  23. Pan SY, Morrison H. Epidemiology of cancer of the small intestine. World J Gastrointest Oncol 2011;3:33-42.
  24. Bernstein H, Bernstein C, Payne CM, Dvorak K. Bile acids as endogenous etiologic agents in gastrointestinal cancer. World J Gastroenterol 2009;15:3329-3340. https://doi.org/10.3748/wjg.15.3329
  25. Arai M, Shimizu S, Imai Y, et al. Mutations of the Ki-ras, p53 and APC genes in adenocarcinomas of the human small intestine. Int J Cancer 1997;70:390-395. https://doi.org/10.1002/(SICI)1097-0215(19970207)70:4<390::AID-IJC3>3.0.CO;2-R
  26. Planck M, Ericson K, Piotrowska Z, Halvarsson B, Rambech E, Nilbert M. Microsatellite instability and expression of MLH1 and MSH2 in carcinomas of the small intestine. Cancer 2003;97:1551-1557. https://doi.org/10.1002/cncr.11197
  27. Neugut AI, Santos J. The association between cancers of the small and large bowel. Cancer Epidemiol Biomarkers Prev 1993;2:551-553.
  28. Chang HK, Yu E, Kim J, et al. Adenocarcinoma of the small intestine: a multi-institutional study of 197 surgically resected cases. Hum Pathol 2010;41:1087-1096. https://doi.org/10.1016/j.humpath.2010.01.006
  29. Talamonti MS, Goetz LH, Rao S, Joehl RJ. Primary cancers of the small bowel: analysis of prognostic factors and results of surgical management. Arch Surg 2002;137:564-570. https://doi.org/10.1001/archsurg.137.5.564
  30. Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J. Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients. Cancer 2004;101:518-526. https://doi.org/10.1002/cncr.20404
  31. Miettinen M, Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med 2006;130:1466-1478.
  32. Patel JK, Didolkar MS, Pickren JW, Moore RH. Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg 1978;135: 807-810. https://doi.org/10.1016/0002-9610(78)90171-X
  33. Crippa S, Bovo G, Romano F, Mussi C, Uggeri F. Melanoma metastatic to the gallbladder and small bowel: report of a case and review of the literature. Melanoma Res 2004;14:427-430. https://doi.org/10.1097/00008390-200410000-00016
  34. Retsas S, Christofyllakis C. Melanoma involving the gastrointestinal tract. Anticancer Res 2001;21(2B):1503-1507.
  35. Wade TP, Goodwin MN, Countryman DM, Johnson FE. Small bowel melanoma: extended survival with surgical management. Eur J Surg Oncol 1995;21:90-91. https://doi.org/10.1016/S0748-7983(05)80078-2
  36. Caputy GG, Donohue JH, Goellner JR, Weaver AL. Metastatic melanoma of the gastrointestinal tract. Results of surgical management. Arch Surg 1991;126:1353-1358. https://doi.org/10.1001/archsurg.1991.01410350043007
  37. Albert JG, Gimm O, Stock K, Bilkenroth U, Marsch WC, Helmbold P. Small-bowel endoscopy is crucial for diagnosis of melanoma metastases to the small bowel: a case of metachronous small-bowel metastases and review of the literature. Melanoma Res 2007;17:335-338. https://doi.org/10.1097/CMR.0b013e3282c3a706
  38. Ciresi DL, Scholten DJ. The continuing clinical dilemma of primary tumors of the small intestine. Am Surg 1995;61:698-702.
  39. Ekberg O, Ekholm S. Radiography in primary tumors of the small bowel. Acta Radiol Diagn (Stockh) 1980;21:79-84. https://doi.org/10.1177/028418518002100111
  40. Bessette JR, Maglinte DD, Kelvin FM, Chernish SM. Primary malignant tumors in the small bowel: a comparison of the small-bowel enema and conventional follow-through examination. AJR Am J Roentgenol 1989;153:741-744. https://doi.org/10.2214/ajr.153.4.741
  41. Minordi LM, Vecchioli A, Guidi L, Mirk P, Fiorentini L, Bonomo L. Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol 2006;16:1527-1536. https://doi.org/10.1007/s00330-006-0185-6
  42. Schmidt S, Felley C, Meuwly JY, Schnyder P, Denys A. CT enteroclysis: technique and clinical applications. Eur Radiol 2006;16:648-660. https://doi.org/10.1007/s00330-005-0005-4
  43. Maglinte DD, Bender GN, Heitkamp DE, Lappas JC, Kelvin FM. Multidetector-row helical CT enteroclysis. Radiol Clin North Am 2003; 41:249-262. https://doi.org/10.1016/S0033-8389(02)00115-X
  44. Boudiaf M, Jaff A, Soyer P, Bouhnik Y, Hamzi L, Rymer R. Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients. Radiology 2004;233:338-344. https://doi.org/10.1148/radiol.2332030308
  45. Kamaoui I, De-Luca V, Ficarelli S, Mennesson N, Lombard-Bohas C, Pilleul F. Value of CT enteroclysis in suspected small-bowel carcinoid tumors. AJR Am J Roentgenol 2010;194:629-633. https://doi.org/10.2214/AJR.09.2760
  46. Van Weyenberg SJ, Meijerink MR, Jacobs MA, et al. MR enteroclysis in the diagnosis of small-bowel neoplasms. Radiology 2010;254:765-773. https://doi.org/10.1148/radiol.09090828
  47. Cheon JH, Kim YS, Lee IS, et al. Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention. Endoscopy 2007;39:1046-1052. https://doi.org/10.1055/s-2007-966978
  48. Costamagna G, Shah SK, Riccioni ME, et al. A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology 2002;123:999-1005. https://doi.org/10.1053/gast.2002.35988
  49. Ell C, Remke S, May A, Helou L, Henrich R, Mayer G. The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy 2002; 34:685-689. https://doi.org/10.1055/s-2002-33446
  50. Saurin JC, Delvaux M, Gaudin JL, et al. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy 2003;35:576-584. https://doi.org/10.1055/s-2003-40244
  51. de Leusse A, Vahedi K, Edery J, et al. Capsule endoscopy or push enteroscopy for first-line exploration of obscure gastrointestinal bleeding? Gastroenterology 2007;132:855-862. https://doi.org/10.1053/j.gastro.2006.12.002
  52. Chen X, Ran ZH, Tong JL. A meta-analysis of the yield of capsule endoscopy compared to double-balloon enteroscopy in patients with small bowel diseases. World J Gastroenterol 2007;13:4372-4378. https://doi.org/10.3748/wjg.v13.i32.4372
  53. Bailey AA, Debinski HS, Appleyard MN, et al. Diagnosis and outcome of small bowel tumors found by capsule endoscopy: a three-center Australian experience. Am J Gastroenterol 2006;101:2237-2243. https://doi.org/10.1111/j.1572-0241.2006.00749.x
  54. Domagk D, Mensink P, Aktas H, et al. Single- vs. double-balloon enteroscopy in small-bowel diagnostics: a randomized multicenter trial. Endoscopy 2011;43:472-476. https://doi.org/10.1055/s-0030-1256247
  55. Takano N, Yamada A, Watabe H, et al. Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial. Gastrointest Endosc 2011;73:734-739. https://doi.org/10.1016/j.gie.2010.10.047
  56. Godeschalk MF, Mensink PB, van Buuren HR, Kuipers EJ. Primary balloon-assisted enteroscopy in patients with obscure gastrointestinal bleeding: findings and outcome of therapy. J Clin Gastroenterol 2010;44:e195-e200. https://doi.org/10.1097/MCG.0b013e3181dd1110
  57. Ross A, Mehdizadeh S, Tokar J, et al. Double balloon enteroscopy detects small bowel mass lesions missed by capsule endoscopy. Dig Dis Sci 2008;53:2140-2143. https://doi.org/10.1007/s10620-007-0110-0
  58. Monkemuller K, Fry LC, Ebert M, et al. Feasibility of double-balloon enteroscopy-assisted chromoendoscopy of the small bowel in patients with familial adenomatous polyposis. Endoscopy 2007;39:52-57. https://doi.org/10.1055/s-2006-945116
  59. Plum N, May AD, Manner H, Ell C. Peutz-Jeghers syndrome: endoscopic detection and treatment of small bowel polyps by double-balloon enteroscopy. Z Gastroenterol 2007;45:1049-1055. https://doi.org/10.1055/s-2007-963345
  60. Kaltsas G, Korbonits M, Heintz E, et al. Comparison of somatostatin analog and meta-iodobenzylguanidine radionuclides in the diagnosis and localization of advanced neuroendocrine tumors. J Clin Endocrinol Metab 2001;86:895-902. https://doi.org/10.1210/jc.86.2.895
  61. Bulow S, Bjork J, Christensen IJ, et al. Duodenal adenomatosis in familial adenomatous polyposis. Gut 2004;53:381-386. https://doi.org/10.1136/gut.2003.027771
  62. Spigelman AD, Williams CB, Talbot IC, Domizio P, Phillips RK. Upper gastrointestinal cancer in patients with familial adenomatous polyposis. Lancet 1989;2:783-785.
  63. Groves CJ, Saunders BP, Spigelman AD, Phillips RK. Duodenal cancer in patients with familial adenomatous polyposis (FAP): results of a 10 year prospective study. Gut 2002;50:636-641. https://doi.org/10.1136/gut.50.5.636
  64. Matsumoto T, Esaki M, Yanaru-Fujisawa R, et al. Small-intestinal involvement in familial adenomatous polyposis: evaluation by double-balloon endoscopy and intraoperative enteroscopy. Gastrointest Endosc 2008;68:911-919. https://doi.org/10.1016/j.gie.2008.02.067
  65. Koornstra JJ, Kleibeuker JH, Vasen HF. Small-bowel cancer in Lynch syndrome: is it time for surveillance? Lancet Oncol 2008;9:901-905. https://doi.org/10.1016/S1470-2045(08)70232-8
  66. Watson P, Vasen HF, Mecklin JP, et al. The risk of extra-colonic, extra-endometrial cancer in the Lynch syndrome. Int J Cancer 2008;123: 444-449. https://doi.org/10.1002/ijc.23508
  67. Kim DW, Kim IJ, Kang HC, et al. Germline mutations of the MYH gene in Korean patients with multiple colorectal adenomas. Int J Colorectal Dis 2007;22:1173-1178. https://doi.org/10.1007/s00384-007-0289-8
  68. Schulmann K, Brasch FE, Kunstmann E, et al. HNPCC-associated small bowel cancer: clinical and molecular characteristics. Gastroenterology 2005;128:590-599. https://doi.org/10.1053/j.gastro.2004.12.051
  69. Saurin JC, Pilleul F, Soussan EB, et al. Small-bowel capsule endoscopy diagnoses early and advanced neoplasms in asymptomatic patients with Lynch syndrome. Endoscopy 2010;42:1057-1062. https://doi.org/10.1055/s-0030-1255742
  70. Utsunomiya J, Gocho H, Miyanaga T, Hamaguchi E, Kashimure A. Peutz-Jeghers syndrome: its natural course and management. Johns Hopkins Med J 1975;136:71-82.
  71. Bosman FT. The hamartoma-adenoma-carcinoma sequence. J Pathol 1999;188:1-2. https://doi.org/10.1002/(SICI)1096-9896(199905)188:1<1::AID-PATH327>3.0.CO;2-J
  72. Giardiello FM, Brensinger JD, Tersmette AC, et al. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology 2000; 119:1447-1453. https://doi.org/10.1053/gast.2000.20228
  73. Hearle N, Schumacher V, Menko FH, et al. Frequency and spectrum of cancers in the Peutz-Jeghers syndrome. Clin Cancer Res 2006;12: 3209-3215. https://doi.org/10.1158/1078-0432.CCR-06-0083
  74. Beggs AD, Latchford AR, Vasen HF, et al. Peutz-Jeghers syndrome: a systematic review and recommendations for management. Gut 2010; 59:975-986. https://doi.org/10.1136/gut.2009.198499
  75. Hemminki A. The molecular basis and clinical aspects of Peutz-Jeghers syndrome. Cell Mol Life Sci 1999;55:735-750. https://doi.org/10.1007/s000180050329
  76. Dunlop MG; British Society for Gastroenterology; Association of Coloproctology for Great Britain and Ireland. Guidance on gastrointestinal surveillance for hereditary non-polyposis colorectal cancer, familial adenomatous polypolis, juvenile polyposis, and Peutz-Jeghers syndrome. Gut 2002;51 Suppl 5:V21-V27. https://doi.org/10.1136/gut.51.suppl_5.v21
  77. Giardiello FM, Trimbath JD. Peutz-Jeghers syndrome and management recommendations. Clin Gastroenterol Hepatol 2006;4:408-415. https://doi.org/10.1016/j.cgh.2005.11.005
  78. Hinds R, Philp C, Hyer W, Fell JM. Complications of childhood Peutz-Jeghers syndrome: implications for pediatric screening. J Pediatr Gastroenterol Nutr 2004;39:219-220. https://doi.org/10.1097/00005176-200408000-00027
  79. Catassi C, Fabiani E, Corrao G, et al. Risk of non-Hodgkin lymphoma in celiac disease. JAMA 2002;287:1413-1419. https://doi.org/10.1001/jama.287.11.1413
  80. Di Sabatino A, Corazza GR. Coeliac disease. Lancet 2009;373:1480-1493. https://doi.org/10.1016/S0140-6736(09)60254-3
  81. Dossett LA, White LM, Welch DC, et al. Small bowel adenocarcinoma complicating Crohn's disease: case series and review of the literature. Am Surg 2007;73:1181-1187.
  82. Albert JG, Fechner M, Fiedler E, et al. Algorithm for detection of small-bowel metastasis in malignant melanoma of the skin. Endoscopy 2011;43:490-498. https://doi.org/10.1055/s-0030-1256357

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