title: Expression of Raf-1 kinase inhibitory protein in carcinoma of the ampulla of Vater.
abstract: Raf-1 kinase inhibitor protein (RKIP) has emerged as a significant metastatic suppressor in a variety of human malignancies. We have recently demonstrated that reduced expression of RKIP is significantly associated with invasion and metastasis in periampullary carcinomas, including pancreatic carcinoma, gallbladder carcinoma, and extrahepatic bile duct carcinoma. In this study, we evaluated RKIP expression in ampulla of Vater (AoV) carcinoma and investigated its prognostic significance. Immunostaining for RKIP was performed for 80 and 21 cases with primary and nodal metastatic AoV carcinoma, respectively. RKIP expression was reduced in 32.5% (26/80) and 66.7% (14/21) of primary and nodal metastatic AoV carcinoma cases, respectively. This distribution of RKIP expression was statistically significant (P < 0.001). The reduction in RKIP expression was significantly associated with the presence of nodal (P = 0.008) and distant (P = 0.002) metastases, a higher TNM stage group (P = 0.010), lymphatic invasion (P < 0.001), vascular invasion (P < 0.001), and a shorter disease-free survival (DFS; P = 0.028) and distant metastasis-free survival (DMFS; P = 0.005). In addition, reduced RKIP expression was an independent prognostic predictor for worse DFS and DMFS (P = 0.032 and P = 0.036, respectively). Our data suggest that a reduction in RKIP expression contributes to invasion and metastasis in AoV carcinoma and is a significant prognostic marker in patients with AoV carcinoma.
authors.affiliation: Aerospace Medical Research Center, Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Chungcheongbuk-do, Republic of Korea.
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sun Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Kyu Yeoun
authors.initials: KY
authors.lastname: Won
authors.forename: Gou Young
authors.initials: GY
authors.lastname: Kim
authors.forename: Yong-Koo
authors.initials: YK
authors.lastname: Park
authors.forename: Youn Wha
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000378:metabolism* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016577:Pancreaticoduodenectomy; D049488:Phosphatidylethanolamine Binding Protein / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; C511482:PEBP1 protein, human; D049488:Phosphatidylethanolamine Binding Protein
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