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Lymph Node Involvement and Not the Histophatologic Subtype Is Correlated with Outcome After Resection of Adenocarcinoma of the Ampulla of Vater
- Source :
- Journal of Gastrointestinal Surgery. 14:719-728
- Publication Year :
- 2010
- Publisher :
- Springer Science and Business Media LLC, 2010.
-
Abstract
- Intestinal and pancreaticobiliary types of Vater’s ampulla adenocarcinoma have been considered as having different biologic behavior and prognosis. The aim of the present study was to determine the best immunohistochemical panel for tumor classification and to analyze the survival of patients having these histological types of adenocarcinoma. Ninety-seven resected ampullary adenocarcinomas were histologically classified, and the prognosis factors were analyzed. The expression of MUC1, MUC2, MUC5AC, MUC6, CK7, CK17, CK20, CD10, and CDX2 was evaluated by using immunohistochemistry. Forty-three Vater’s ampulla carcinomas were histologically classified as intestinal type, 47 as pancreaticobiliary, and seven as other types. The intestinal type had a significantly higher expression of MUC2 (74.4% vs. 23.4%), CK20 (76.7% vs. 29.8%), CDX2 (86% vs. 21.3%), and CD10 (81.4% vs. 51.1%), while MUC1 (53.5% vs. 82.9%) and CK7 (79.1% vs. 95.7%) were higher in pancreatobiliary adenocarcinomas. The most accurate markers for immunohistochemical classification were CDX2, MUC1, and MUC2. Survival was significantly affected by pancreaticobiliary type (p = 0.021), but only lymph node metastasis, lymphatic invasion, and stage were independent risk factors for survival in a multivariate analysis. The immunohistochemical expression of CDX2, MUC1, and MUC2 allows a reproducible classification of ampullary carcinomas. Although carcinomas of the intestinal type showed better survival in the univariate analysis, neither histological classification nor immunohistochemistry were independent predictors of poor prognosis.
- Subjects :
- Ampulla of Vater
Pathology
medicine.medical_specialty
Lymphovascular invasion
Common Bile Duct Neoplasms
Adenocarcinoma
Sensitivity and Specificity
digestive system
medicine
Humans
CDX2 Transcription Factor
Stage (cooking)
Ampulla
Lymph node
Proportional Hazards Models
Homeodomain Proteins
Mucin-2
Univariate analysis
Chi-Square Distribution
business.industry
Mucin-1
Gastroenterology
Microarray Analysis
Prognosis
medicine.disease
Immunohistochemistry
Survival Analysis
digestive system diseases
medicine.anatomical_structure
Lymphatic Metastasis
Linear Models
Surgery
business
Subjects
Details
- ISSN :
- 18734626 and 1091255X
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Journal of Gastrointestinal Surgery
- Accession number :
- edsair.doi.dedup.....2440dcc2c3c03d51dedee357a49d1c2b