EVIDENCE FOR ADENOMA-CARCINOMA SEQUENCE IN THE DUODENUM OF PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS

Aims-To explore the association between duodenal adenoma and carcinoma in patients with familial adenomatous polyposis (FAP). Methods-A mult icentre survey of 1262 patients with FAP yielded 47 cases of duodenal cancer. The association between adenoma and cancer was assessed in the se cases. Results-Adenomatous tissue was found within duodenal cancer in 29 of 44 (66%) patients with FAP and in mucosa adjacent to duodenal cancer in 31 of 42 (73%) such patients. Adenomas were found as a comp onent of, or adjacent to, duodenal cancer in 38 of 45 (84%) patients. Conclusions-These observations support the existence of the adenomacar cinoma sequence in the duodenum of patients with FAP. Factors associat ed with malignant change included villous histology, moderate or sever e dysplasia, and the presence of stage IV duodenal polyposis.