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Type:	Artigo de Periódico
Title:	Immunohistochemical predictors for intestinal and pancreatobiliary types of adenocarcinoma of the ampulla of vater
Authors:	João Paulo Lemosda Silveira Santos Carla Jorge Machado Eduardo Paulino Junior João Bernardo Sancio Rocha Rodrigues Paula Teixeira Vidigal Vivian Resende
Abstract:	Objectives To investigate immunohistochemical predictors for intestinal and pancreatobiliary types of adenocarcinoma of ampulla of Vater and identify clinicopathological characteristics associated with the histological types and patient survival. Methods Immunohistochemical markers included MUC1, MUC2, MUC5AC, CDX2, CK7, and CK20. The data were analyzed by univariate and multivariate methods. The two-step cluster method was used to determine the best immunohistochemical markers to discriminate the intestinal from the pancreatobiliary type. Results This study identified 9 (33.3%) intestinal and 21 (66.7%) pancreatobiliary tumors. CK7 and CDX2 achieved the highest value (= 1) as predictor markers, while CK20, MUC1, and MUC2 showed degrees of importance equal to 0.77, 0.71, and 0.68, respectively. MUC5AC did not reach 0.50 of importance. In the univariate analysis, lymph node involvement, staging (TNM), and angiolymphatic and perineural invasions were associated with histological types. The independent clinicopathological variable in the multivariate model to predict the histological type was angiolymphatic invasion (p = 0.005), OR = 17 (95% CI 2.33 to 123.83). The final model showed positive nodes (N1) associated with shorter survival (HR = 9.5; p = 0.006). Overallsurvival at 12, 36, and 60 months was 88.5, 67.0, and 47.6%, respectively. Conclusions CDX2 and CK7 were the immunohistochemical markers that best discriminated the intestinal from the pancreatobiliary type. Lymph node involvement had a high impact on survival and proved to be more frequent in the pancreatobiliary type.
Subject:	Ampola Hepatopancreática Adenocarcinoma Sebáceo Imuno-Histoquímica Survival
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	ICB - DEPARTAMENTO DE MORFOLOGIA MED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGAL MED - DEPARTAMENTO DE CIRURGIA MED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIAL
Rights:	Acesso Aberto
metadata.dc.identifier.doi:	https://10.1007/s11605-018-3797-7
URI:	http://hdl.handle.net/1843/55133
Issue Date:	7-May-2018
metadata.dc.url.externa:	https://link.springer.com/article/10.1007/s11605-018-3797-7
metadata.dc.relation.ispartof:	Journal of Gastrointestinal Surgery
Appears in Collections:	Artigo de Periódico

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