title: Promyelocytic leukemia (PML) gene expression is a prognostic factor in ampullary cancer patients.
abstract: BACKGROUND
  Promyelocytic leukemia (PML) tumor suppressor gene plays a key role in acute PML pathogenesis but its involvement in pathogenesis and prognosis of solid cancers has not been defined yet.
  
  
  METHODS
  In all, 62 ampullary adenocarcinoma patients who underwent curative surgery between 1996 and 2005 were included. Expression analysis of PML was carried out by immunohistochemical staining and correlated with disease-free survival (DFS) and overall survival (OS).
  
  
  RESULTS
  In 24 tumor specimens (38.7%), PML was classified as absent, in 16 (25.8%) as focally expressed and in 22 (35.5%) as diffusely expressed. By univariate analysis, DFS was significantly influenced by pathological T stage (P=0.03), lymph nodal involvement (P=0.002), and PML expression (P=0.001). DFS in patients without PML expression was 28.0 months versus 45.1 and 75.5 for patients with focal and diffuse expression, respectively. OS in the group of patients without PML expression, with focal expression, and with diffuse expression was 40, 48, and 77 months, respectively (P=0.002). By a multivariate analysis, PML expression was the strongest prognostic factor for DFS (P=0.003) and the only statically significant prognostic factor for OS (P=0.009).
  
  
  CONCLUSIONS
  Our preliminary data suggest PML as a novel prognostic tool for ampullary cancer patients.
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Vincenzi
authors.forename: D
authors.initials: D
authors.lastname: Santini
authors.forename: G
authors.initials: G
authors.lastname: Perrone
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.forename: V
authors.initials: V
authors.lastname: Adamo
authors.forename: S
authors.initials: S
authors.lastname: Rizzo
authors.forename: F
authors.initials: F
authors.lastname: Castri
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.forename: R
authors.initials: R
authors.lastname: Alloni
authors.forename: P F
authors.initials: PF
authors.lastname: Crucitti
authors.forename: S
authors.initials: S
authors.lastname: Morini
authors.forename: C
authors.initials: C
authors.lastname: Rabitti
authors.forename: F M
authors.initials: FM
authors.lastname: Vecchio
authors.forename: P
authors.initials: P
authors.lastname: Magistrelli
authors.forename: R
authors.initials: R
authors.lastname: Coppola
authors.forename: G
authors.initials: G
authors.lastname: Tonini
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D015331:Cohort Studies; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000235:genetics / Q000378:metabolism*; D011379:Prognosis; D000071156:Promyelocytic Leukemia Protein; D012189:Retrospective Studies; D016019:Survival Analysis; D014157:Transcription Factors / Q000235:genetics / Q000378:metabolism*; D025521:Tumor Suppressor Proteins / Q000235:genetics / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D009687:Nuclear Proteins; D000071156:Promyelocytic Leukemia Protein; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; C070576:PML protein, human