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A retrospective multicenter analysis followed biopsy-diagnosed SNDA patients from April 2010 to March 2016 across 13 institutions with centralized central re-evaluation of specimens. Among 121 lesions observed for a median 32.7 months, 5 developed carcinoma; tumor enlargement occurred in 22 lesions. Male sex, larger initial lesion size, and non–pure intestinal phenotype predicted carcinoma, while lesion size, erythematous appearance, high-grade adenoma, Ki67 status, and non–pure phenotype predicted enlargement.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/nonpure-intestinal-phenotype-as-an-indicator-of-progression-in-sporadic-nonampullary-duodenal-adenomas-a-multicenter-retrospective-cohort-study/326749/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/nonpure-intestinal-phenotype-as-an-indicator-of-progression-in-sporadic-nonampullary-duodenal-adenomas-a-multicenter-retrospective-cohort-study/326749.png","ImageObject",300,407,{"name":92,"@type":93},"Logic","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-21","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the primary aim of this study on sporadic nonampullary duodenal adenomas (SNDAs)?","Question",{"text":112,"@type":113},"To evaluate the natural course of SNDAs and identify risk factors associated with progression, including progression to carcinoma and tumor enlargement.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were mucinous phenotypes classified in the analysis?",{"text":117,"@type":113},"Mucinous phenotypes were classified into pure intestinal and non–pure intestinal phenotypes based on the pathology findings.",{"name":119,"@type":110,"acceptedAnswer":120},"Which factors were significantly associated with progression to carcinoma?",{"text":121,"@type":113},"Male sex, an initial lesion size ≥10 mm, and a non–pure intestinal phenotype were significantly associated with progression to carcinoma.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},326749,1790578504,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","ARTICLE 1  \n\n| INTRODUCTION: We aimed to evaluate the natural course of sporadic nonampullary duodenal adenomas (SNDAs) and determine the risk factors of progression.\u003Cbr>METHODS: We retrospectively analyzed the follow-up outcomes of patients with biopsy-diagnosed SNDA between April2010and March2016at13institutions. All initial biopsy specimens were centrally evaluated. Only those diagnosed with adenomas were included. Mucinous phenotypes were classified into pure intestinal and non–pure intestinal phenotypes. Cumulative incidence rates of carcinoma and tumor enlargement were evaluated. Tumor enlargement was defined as a ‡25% or 5-mm increase in tumor size.\u003Cbr>RESULTS: Overall, 121 lesions were analyzed. Within a median observation period of 32.7 months, 5 lesions were diagnosed as carcinomas; the cumulative 5-year incidence of carcinoma was 9.5% . Male sex (P 5 0.046), initial lesion size ‡10 mm (P 5 0.044), and non–pure intestinal phenotype (P 5 0.019) were significantly associated with progression to carcinoma. Tumor enlargement was observed in 22 lesions, with a cumulative5-year incidence of33.9% . Initial lesion size‡10mm(P\u003C 0.001), erythematouslesion (P 5 0.002), high-grade adenoma (P 5 0.002), Ki67 negative (P 5 0.007), and non–pure intestinal phenotype(P 5 0.001) were risk factors of tumor enlargement. Ina multivariate analysis, an initial lesion size ‡10 mm (P 5 0.010) and non–pure intestinal phenotype (P 5 0.046) were independent and significant risk factors of tumor enlargement.\u003Cbr>DISCUSSION: Lesion size ‡10 mm and non–pure intestinal phenotype on initial biopsy are risk factors of cancer progression and tumor enlargement in cases with SNDA. Thus, management effectiveness may be improved by focusing on lesion size and the mucinous phenotype.\u003Cbr>KEYWORDS: mucinous phenotype; natural course; sporadic nonampullary duodenal adenoma; tumor progression\u003Cbr>SUPPLEMENTARY MATERIAL accompanies this paper at [http://links.lww.com/CTG/B25](http://links.lww.com/CTG/B25) |\n| --- |\n| Clinical and Translational Gastroenterology 2024;15:e00649. [https://doi.org/10.14309/ctg.0000000000000649](https://doi.org/10.14309/ctg.0000000000000649) |\n\nNon–Pure Intestinal Phenotype as an Indicator of Progression in Sporadic Nonampullary Duodenal Adenomas: A Multicenter Retrospective Cohort Study  \nRyotaro Uema, MD, PhD1, Yoshito Hayashi, MD, PhD 1, Masato Komori, MD, PhD2, Narihiro Shibukawa, MD3, Noriko Hayashi, MD4 , Masayoshi Horimoto, MD, PhD5, Takuya Yamada, MD, PhD6, Masashi Yamamoto, MD7, Satoshi Hiyama, MD, PhD8 ,  \nKazuo Kinoshita, MD, PhD9, Hideharu Ogiyama, MD, PhD10, Shinjiro Yamaguchi, MD, PhD11, Satoshi Egawa, MD, PhD 12 ,  \nTakashi Kanesaka, MD13, Minoru Kato, MD, PhD1, Shunsuke Yoshii, MD, PhD1, Yoshiki Tsujii, MD, PhD 1, Honma Keiichiro, MD, PhD 14 , 15 , Shinichiro Shinzaki, MD, PhD1, Hideki Iijima, MD, PhD1 , 12, Eiichi Morii, MD, PhD 15 and Tetsuo Takehara, MD, PhD1  \nSMALL BOWEL  \n1Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; 2Department of Gastroenterology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan; 3Department of Gastroenterology, Daini Osaka Police Hospital, Osaka, Osaka, Japan; 4Department of Gastroenterology, Nishinomiya Municipal Central Hospital, Nishinomiya, Hyogo, Japan; 5Department of Gastroenterology, Saiseikai Senri Hospital, Suita, Osaka, Japan; 6Department of Gastroenterology, Osaka Rosai Hospital, Sakai, Osaka, Japan; 7 Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan; 8Department of Gastroenterology, Japan Community Health Care Organization Osaka Hospital, Osaka, Osaka, Japan; 9Department of Gastroenterology, Otemae Hospital, Osaka, Osaka, Japan; 10 Department of Gastroenterology, Itami City Hospital, Itami, Hyogo, Japan; 11Department of Gastroenterology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan; 12Department of Internal Medicine, Osaka Police Hospital, Osaka, Osaka, Japan; 13","cbCaitkloUeAuUt3","https://ap.wps.com/l/cbCaitkloUeAuUt3","pdf",1122567,12,"English","# Introduction\n# Methods\n# Results\n# Discussion\n# Keywords","[{\"question\":\"What was the primary aim of this study on sporadic nonampullary duodenal adenomas (SNDAs)?\",\"answer\":\"To evaluate the natural course of SNDAs and identify risk factors associated with progression, including progression to carcinoma and tumor enlargement.\"},{\"question\":\"How were mucinous phenotypes classified in the analysis?\",\"answer\":\"Mucinous phenotypes were classified into pure intestinal and non–pure intestinal phenotypes based on the pathology findings.\"},{\"question\":\"Which factors were significantly associated with progression to carcinoma?\",\"answer\":\"Male sex, an initial lesion size ≥10 mm, and a non–pure intestinal phenotype were significantly associated with progression to carcinoma.\"}]","Non–Pure Intestinal Phenotype as an Indicator of Progression in Sporadic Nonampullary Duodenal Adenomas - A Multicenter Retrospective Cohort Study | PDF",1789975250]