Prognostic factors for ampullary adenocarcinomas: tumor stage, tumor histology, tumor location, immunohistochemistry and microsatellite instability

Sessa, Fausto; Furlan, Daniela; Zampatti, C; Carnevali, Ileana; Franzi, Francesca; Capella, Carlo

doi:10.1007/s00428-007-0444-1

Cited by 94 publications

(82 citation statements)

References 31 publications

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“…Seven patients were excluded because, resection margins, lower histologic grade, and small tumor size are known to improve survival in ampullary carcinoma, whereas an ulcerative gross type shows a poorer prognosis than do other gross types ( 4,(8)(9)(10)(11)(12)(13). In addition, fi ndings in several studies suggest that histologic type might be an independent prognostic factor for prediction of survival ( 2,3,5,(14)(15)(16)(17)(18).…”

Section: Gastrointestinal Imaging: Pancreatobiliary and Intestinal Ammentioning

confidence: 99%

Differential Features of Pancreatobiliary- and Intestinal-type Ampullary Carcinomas at MR Imaging

et al. 2010

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Purpose:To defi ne the differential imaging features of pancreatobiliaryand intestinal-type ampullary carcinomas at magnetic resonance (MR) imaging and to correlate these features with pathologic fi ndings. Materials and Methods:This retrospective study was approved by the institutional review board; informed consent was waived. Fifty patients with surgically confi rmed ampullary carcinoma and preoperative MR results were included. Two radiologists, blinded to histologic type of cancer, evaluated imaging fi ndings in consensus. Univariate and multiple logistic regression analysis were performed to defi ne imaging fi ndings that were useful for differentiation of the two types of carcinomas. Results:On with an extramural protruding mass ( n = 15, 100%) with a papillary surface ( n = 11, 73%), whereas pancreatobiliary carcinoma manifested with intramural protruding ( n = 5, 28%) or ulcerating ( n = 1, 6%) gross morphologic features ( P = .047) with a nonpapillary surface ( n = 17, 94%) ( P , .001). Multiple logistic regression analysis showed that an oval fi lling defect at the distal end of the bile duct was the only independent fi nding for differentiating intestinal from pancreatobiliary carcinoma ( P = .027). Conclusion:An oval fi lling defect at the distal end of the bile duct on MRCP images and an extramural protruding appearance with a papillary surface at endoscopy are likely to suggest intestinal ampullary carcinoma.q RSNA, 2010 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Section: Gastrointestinal Imaging: Pancreatobiliary and Intestinal Ammentioning

confidence: 99%

Differential Features of Pancreatobiliary- and Intestinal-type Ampullary Carcinomas at MR Imaging

et al. 2010

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“…Conflicting data have been reported about the frequency of these two histological types due to the absence of reliable and consistent histomorphological criteria for differential diagnosis. [6][7][8][9] MicroRNAs are 19-25-nucleotide-long non-coding RNAs which after cleavage of a precursor into their mature form bind to the RNA-inducedsilencing-complex (RISC) and regulate gene expression posttranscriptionally by a binding of specific mRNA. MicroRNAs regulate many genes known to play important roles in oncogenesis, angiogenesis and tissue differentiation.…”

mentioning

confidence: 99%

MicroRNA expression profiles associated with pancreatic adenocarcinoma and ampullary adenocarcinoma

Schultz

Werner

Willenbrock³

et al. 2012

Modern Pathology

135

106

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MicroRNAs have potential as diagnostic cancer biomarkers. The aim of this study was (1) to define microRNA expression patterns in formalin-fixed parafin-embedded tissue from pancreatic ductal adenocarcinoma, ampullary adenocarcinoma, normal pancreas and chronic pancreatitis without using micro-dissection and (2) to discover new diagnostic microRNAs and combinations of microRNAs in cancer tissue. The expression of 664 microRNAs in tissue from 170 pancreatic adenocarcinomas and 107 ampullary adenocarcinomas were analyzed using a commercial microRNA assay. Results were compared with chronic pancreatitis, normal pancreas and duodenal adenocarcinoma. In all, 43 microRNAs had higher and 41 microRNAs reduced expression in pancreatic cancer compared with normal pancreas. In all, 32 microRNAs were differently expressed in pancreatic adenocarcinoma compared with chronic pancreatitis (17 higher; 15 reduced). Several of these microRNAs have not before been related to diagnosis of pancreatic cancer (eg, miR-492, miR-614, miR-622). MiR-614, miR-492, miR-622, miR-135b* and miR-196 were most differently expressed. MicroRNA profiles of pancreatic and ampullary adenocarcinomas were correlated (0.990). MicroRNA expression profiles for pancreatic cancer described in the literature were consistent with our findings, and the microRNA profile for pancreatic adenocarcinoma (miR-196b-miR-217) was validated. We identified a more significant expression profile, the difference between miR-411 and miR-198 (P ¼ 2.06 Â 10 À 54 ) and a diagnostic LASSO classifier using 19 microRNAs (sensitivity 98.5%; positive predictive value 97.8%; accuracy 97.0%). We also identified microRNA profiles to subclassify ampullary adenocarcinomas into pancreatobiliary or intestinal type. In conclusion, we found that combinations of two microRNAs could roughly separate neoplastic from nonneoplastic samples. A diagnostic 19 microRNA classifier was constructed which without micro-dissection could discriminate pancreatic and ampullary adenocarcinomas from chronic pancreatitis and normal pancreas with high sensitivity and accuracy. Ongoing prospective studies will evaluate if these microRNA profiles are useful on fine-needle biopsies for early diagnosis of pancreatic cancer. Modern Pathology (2012Pathology ( ) 25, 1609Pathology ( -1622 doi:10.1038/modpathol.2012; published online 10 August 2012Keywords: ampullary adenocarcinoma; chronic pancreatitis; microRNA; normal pancreas; pancreatic adenocarcinoma; pancreatic cancer Pancreatic cancer is the fourth most common cause of cancer death in United States and Europe. 1,2 Less than 20% of the patients can be operated with curative intent and the 5-year survival after surgery is below 20%. 3 Early diagnosis is difficult and the clinical and histological similarities between pancreatic cancer and chronic pancreatitis further complicate the differentiation between inflammation and cancer.

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“…Moreover, molecular classification makes it possible to observe different biological behaviors and distinguish two subtypes of AAC based on immunohistochemistry Chu et al 2005;Sessa et al 2007;Amptoulach et al 2011;Westgaard et al 2013). Specially, the intestinal epithelial-specific marker, caudaltype homeodomain transcription factor 2 (CDX2) was an independent good prognostic marker for resected AAC (Hansel et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Better Outcome of XELOX Chemotherapy in Patients with Advanced Intestinal-Type Adenocarcinoma of the Ampulla of Vater

Kim¹,

Shin²,

Kim³

et al. 2013

Tohoku J. Exp. Med.

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Prognostic factors for ampullary adenocarcinomas: tumor stage, tumor histology, tumor location, immunohistochemistry and microsatellite instability

Cited by 94 publications

References 31 publications

Differential Features of Pancreatobiliary- and Intestinal-type Ampullary Carcinomas at MR Imaging

Differential Features of Pancreatobiliary- and Intestinal-type Ampullary Carcinomas at MR Imaging

MicroRNA expression profiles associated with pancreatic adenocarcinoma and ampullary adenocarcinoma

Better Outcome of XELOX Chemotherapy in Patients with Advanced Intestinal-Type Adenocarcinoma of the Ampulla of Vater

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