title: Sporadic nonampullary duodenal adenoma/carcinoma is associated with not only colon adenoma/carcinoma but also gastric cancer: association of location of duodenal lesions with comorbid diseases.
abstract: BACKGROUND
  It is well known that in patients with sporadic nonampullary duodenal adenoma/carcinoma (SNADA) with no polyposis syndrome, including familial adenomataous polyposis, the rates of colorectal adenoma/carcinoma are high. However, the prevalence rates of other tumor types, for example, gastric cancer, in SNADA patients remain unknown. In this study, we aimed to analyze the prevalence rate of comorbid diseases in SNADA patients.
  
  
  METHODS
  We retrospectively analyzed 78 patients with SNADA treated by endoscopic resection between May 2005 and September 2014 at our institution.
  
  
  RESULTS
  Overall, 51 of the 78 (65.4%) SNADA patients had comorbid colorectal adenoma/carcinoma. Further, 10 of the 78 (12.8%) SNADA patients had comorbid gastric cancer, and all of them were positive for Helicobacter pylori infection. SNADA lesions were located significantly more frequently at the oral side of the major papilla in patients with H. pylori infection than in those without H. pylori infection (27 of 36 [75.0%] vs. 19 of 42 [45.2%], p = 0.008, chi-square test). In contrast, SNADA lesions were located significantly more frequently at the anal side of the major papilla in patients with colorectal adenoma/carcinoma than in those without colorectal adenoma/carcinoma (27 of 51 [52.9%] vs. 5 of 27 [18.5%], p = 0.003, chi-square test).
  
  
  CONCLUSIONS
  SNADA patients showed comorbidity with not only colorectal adenoma/carcinoma but also gastric cancer. H. pylori infection is known to cause gastric cancer and may influence tumorigenesis of SNADA lesions at the oral side of the major papilla.
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University , Chiba , Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Maruoka
authors.forename: Makoto
authors.initials: M
authors.lastname: Arai
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ishigami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Okimoto
authors.forename: Keiko
authors.initials: K
authors.lastname: Saito
authors.forename: Shoko
authors.initials: S
authors.lastname: Minemura
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Matsumura
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Katsuno
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology; D001706:Biopsy; D063646:Carcinogenesis; D015179:Colorectal Neoplasms / Q000150:complications* / Q000473:pathology; D004379:Duodenal Neoplasms / Q000150:complications*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology
keywords: Helicobacter pylori; colorectal adenoma; duodenal adenoma; gastric cancer