Immunohistochemical predictors for intestinal and pancreatobiliary types of adenocarcinoma of the ampulla of vater
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Membros da banca
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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.
Abstract
Assunto
Ampola Hepatopancreática, Adenocarcinoma Sebáceo, Imuno-Histoquímica, Survival
Palavras-chave
Ampulla of Vater, Adenocarcinoma, Immunohistochemistry, Survival
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Curso
Endereço externo
https://link.springer.com/article/10.1007/s11605-018-3797-7