title: The clinicopathologic and immunohistochemical characteristics of ampulla of Vater carcinoma: the intestinal type is associated with a better prognosis.
abstract: OBJECTIVE
  We wanted to compare the clinicopathological parameters with the immunohistochemical expression patterns and patient survival for the intestinal type (IT) and the pancreatobiliary type (PT) of ampulla of Vater carcinoma. Ampulla of Vater carcinoma can be classified histologically into either IT or PT. The biologic behavior and patient prognosis vary considerably in relation to the tumor type.
  
  
  METHODS
  From September, 1995, to February, 2004, 34 patients with the pathologic diagnosis of ampulla of Vater carcinoma were retrospectively reviewed and the prognostic factors were analyzed. To classify the phenotypes of the tumors, the keratin types (CK7 and CK20), the type of apomucin of the mucosa (MUC2), and the glucose transporter (GLUT1) were studied for differentiating the tumor types.
  
  
  RESULTS
  The 5-year survival rate of the 34 patients with ampulla of Vater carcinoma was 58.8%. Histologically, 12 patients had IT and 22 had PT, and the IT patients all survived. The long-term survival after resection of the tumor was significantly greater for the patients with IT than for the patients with PT. Although these differences were not statistically significant, the prognosis of IT group seemed more favorable (p = 0.0955). On the immunohistochemical staining, MUC2 (p < 0.0001), CK20 (p = 0.0002) and CK7 (p = 0.0368) were statistically effective, but not GLUT1, for differentiating IT from PT.
  
  
  CONCLUSIONS
  For the classification of the tumor phenotypes, performing immunohistochemical staining were helpful to differentiate the two types of tumor. A study with a larger number samples would probably elucidate the different clinical course between these two types of ampulla of Vater carcinoma.
authors.affiliation: Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Roh
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Hyoun-Wook
authors.initials: HW
authors.lastname: Lee
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Mee-Sook
authors.initials: MS
authors.lastname: Roh
authors.forename: Jin-Sook
authors.initials: JS
authors.lastname: Jeong
authors.forename: Ghap-Joong
authors.initials: GJ
authors.lastname: Jung
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology*; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D051272:Glucose Transporter Type 1 / Q000096:biosynthesis; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D053554:Keratin-20 / Q000096:biosynthesis; D053552:Keratin-7 / Q000096:biosynthesis; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D055262:Mucin-2; D009077:Mucins / Q000096:biosynthesis; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D051272:Glucose Transporter Type 1; D053554:Keratin-20; D053552:Keratin-7; C524625:MUC2 protein, human; D055262:Mucin-2; D009077:Mucins; C495677:SLC2A1 protein, human