Risk factors for small intestinal adenocarcinomas that are common in the proximal small intestine  

作　　者：Shunji Fujimori Ryohei Hamakubo Aitoshi Hoshimoto Takayoshi Nishimoto Jun Omori Naohiko Akimoto Shu Tanaka Atsushi Tatsuguchi Katsuhiko Iwakiri 

机构地区：[1]Department of Gastroenterology,Chiba Hokusoh Hospital,Nippon Medical School,Chiba 270-1694,Japan [2]Department of Gastroenterology,Nippon Medical School,Graduate School of Medicine,Tokyo 113-8603,Japan [3]Department of Gastroenterology,Tama-Nagayama Hospital,Nippon Medical School,Tokyo 206-0025,Japan

出　　处：《World Journal of Gastroenterology》2022年第39期5658-5665,共8页世界胃肠病学杂志（英文版）

摘　　要：The frequency of primary small intestinal adenocarcinoma is increasing but is still low.Its frequency is approximately 3%of that of colorectal adenocarcinoma.Considering that the small intestine occupies 90%of the surface area of the gastrointestinal tract,small intestinal adenocarcinoma is very rare.The main site of small intestinal adenocarcinoma is the proximal small intestine.Based on this characteristic,dietary animal proteins/lipids and bile concentrations are implicated and reported to be involved in carcinogenesis.Since most nutrients are absorbed in the proximal small intestine,the effect of absorbable intestinal content is a suitable explanation for why small intestinal adenocarcinoma is more common in the proximal small intestine.The proportion of aerobic bacteria is high in the proximal small intestine,but the absolute number of bacteria is low.In addition,the length and density of villi are greater in the proximal small intestine.However,the involvement of villi is considered to be low because the number of small intestinal adenocarcinomas is much smaller than that of colorectal adenocarcinomas.On the other hand,the reason for the low incidence of small intestinal adenocarcinoma in the distal small intestine may be that immune organs reside there.Genetic and disease factors increase the likelihood of small intestinal adenocarcinoma.In carcinogenesis experiments in which the positions of the small and large intestines were exchanged,tumors still occurred in the large intestinal mucosa more often.In other words,the influence of the intestinal contents is small,and there is a large difference in epithelial properties between the small intestine and the large intestine.In conclusion,small intestinal adenocarcinoma is rare compared to large intestinal adenocarcinoma due to the nature of the epithelium.It is reasonable to assume that diet is a trigger for small intestinal adenocarcinoma.

关 键 词：Small intestine Large intestine ADENOCARCINOMA Risk factor CARCINOGENESIS 

分 类 号：R735.32[医药卫生—肿瘤]