TY - JOUR
TI - Differential Expression of beta-Catenin, EGFR, CK7, CK20, MUC1, MUC2,
and CDX2 in Intestinal and Pancreatobiliary-Type Ampullary Carcinomas
AU - Perysinakis, Iraklis
AU - Minaidou, Emilia
AU - Leontara, Vasileia and
AU - Mantas, Dimitrios
AU - Sotiropoulos, Georgios C.
AU - Tsipras, Hercules
AU - and Zografos, George N.
AU - Margaris, Ilias
AU - Kouraklis, Gregory
JO - International Journal of Surgical Pathology
PY - 2017
VL - 25
TODO - 1
SP - 31-40
PB - SAGE Publications Inc.
SN - 1066-8969
TODO - 10.1177/1066896916664987
TODO - ampullary adenocarcinoma; beta-catenin; EGFR; intestinal;
pancreatobiliary; prognosis
TODO - Introduction: The purpose of this study was to associate
immunohistochemical expression of -catenin, EGFR, CK7, CK20, MUC1, MUC2,
and CDX2 in ampullary adenocarcinomas with the type of differentiation
and prognosis. Methods: Forty-seven patients with ampullary
adenocarcinoma who underwent pancreatoduodenectomy with curative intent
from 1997 to 2014 were included in this study. Nine patients with
perioperative death were included in the association analysis but
excluded from survival analysis. All tumors were classified as
intestinal or pancreatobiliary type, according to histologic criteria,
and immunohistochemically stained against the aforementioned markers.
Results: Eighteen carcinomas were classified as intestinal type and 29
carcinomas as pancreatobiliary type. Univariate analysis revealed that
CK20 and CDX2 expression correlates with intestinal type, whereas MUC1
positivity indicates pancreatobiliary type. A marginally significant
trend was shown for intestinal-type tumors toward larger size and more
frequent MUC2 expression. Using multivariate analysis CK20 (P = .003)
and MUC1 (P = .004) were identified as independent predictors of the
intestinal and pancreatobiliary types, respectively. Mean and median
survival was 90.3 and 55 months, respectively. Overall 5-year survival
rate was 48%. On univariate survival analysis, overall survival was
adversely influenced by the number of infiltrated lymph nodes, elevated
Ca19-9 serum levels, jaundice, poor differentiation, T4 stage, N1 stage,
TNM stage III, and CDX2 immunonegativity. Multivariate analysis
identified TNM stage as the only independent prognostic factor in
ampullary adenocarcinoma (P = .048). Conclusions: Immunoreactivity
against CK20 and MUC1 in ampullary carcinomas is a useful adjunct to
histologic examination in determining histotype. None of the
immunohistochemical markers studied had prognostic significance.
ER -