title: Endocrine cells in ampullary carcinoma.
abstract: OBJECTIVE
  As ampullary carcinoma originates from four anatomical regions, it may have different behaviors depending on its origin. We documented the presence of endocrine cells found in ampullary carcinoma, and we studied the clinicopathological implications of their presence.
  
  
  METHODS
  We immunohistochemically examined the presence of an endocrine component in 62 surgically resected specimens of ampullary carcinoma, and we studied the clinicopathological differences between endocrine component-positive cases and endocrine component-negative cases.
  
  
  RESULTS
  Endocrine cells were detected in 16 cases (26%); 11 cases had many endocrine cells, and five cases had scattered endocrine cells. Serotonin-positive cells were detected in all 16 cases, in which six cases had many positive cells. Several somatostatin-positive cells were detected in three cases. Endocrine cells were detected in ampulloduodenal polypoid lesions (two cases) and ampullopancreaticobiliary ducts (14 cases). The histology of 15 of the 16 endocrine component-positive ampullary carcinomas was the intestinal type. Pancreatic invasion and lymph node involvement were observed less frequently in endocrine component-positive cases (P < 0.01). There were no significant differences with respect to immunoreactivity for carbohydrate antigen (CA) 19.9, carcinembryonic antigen (CEA), and p53 overexpression, and K-ras mutations.
  
  
  CONCLUSIONS
  Endocrine component-positive ampullary carcinoma seemed to be derived from the ampullopancreaticobiliary common duct or the ampulloduodenum, and to behave less aggressively than endocrine component-negative carcinoma.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. kamisawa@cick.jp
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Yuyang
authors.initials: Y
authors.lastname: Tu
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Atsutake
authors.initials: A
authors.lastname: Okamoto
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Funata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology*; D001707:Biopsy, Needle; D002272:Carcinoembryonic Antigen / Q000235:genetics; D003138:Common Bile Duct Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D055098:Endocrine Cells / Q000473:pathology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D011905:Genes, ras; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009361:Neoplasm Invasiveness / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012307:Risk Factors; D012494:Sampling Studies; D012680:Sensitivity and Specificity
chemical_list: D002272:Carcinoembryonic Antigen