Ampullary cancer--a separate clinical entity?
OBJECTIVE
Ampullary cancer is a relatively uncommon tumour, with a better prognosis than pancreatic cancer. The purpose of this study was to review the recent literature on ampullary adenocarcinoma, focusing on histological types and prognostic factors.


RESULTS
Using PubMed, we carried out a comprehensive search of the literature, which was extended to April 2013 to retrieve all additional publications. Ampullary cancer comprises two main histological subtypes, the pancreatobiliary type and the intestinal type. These subtypes have different pathogenetic and clinical characteristics. Clinical and histological parameters as well as immunohistochemical markers have been identified as significant prognostic factors in ampullary cancer. Moreover, several immunohistochemical markers have been studied, not only as prognostic factors but as a means of differentiating ampullary from other peri-ampullary tumours, and of identifying the exact histological subtype.


CONCLUSIONS
The considerable differences in the frequencies of the two subtypes of ampullary tumours reported in literature reinforce the necessity to define molecular markers to distinguish them. Until then, the significance of the histological subtype as a prognostic factor should be evaluated cautiously. Future research on the pathogenesis of ampullary cancer will possibly suggest that we should stop treating this type of cancer as a separate entity.
Third Department of Surgery, 'George Gennimatas' General Hospital, Athens, Greece.
Iraklis
I
Perysinakis
Ilias
I
Margaris
Gregory
G
Kouraklis
D000230:Adenocarcinoma / Q000473:pathology*; D014670:Ampulla of Vater / Q000473:pathology*; D014408:Biomarkers, Tumor; D003138:Common Bile Duct Neoplasms / Q000473:pathology*; D006801:Humans; D011379:Prognosis
D014408:Biomarkers, Tumor
ampullary cancer; differentiation; immunohistochemical markers; intestinal; pancreatobiliary