Clinical impact of ampulla of Vater cancer subtype classification based on immunohistochemical staining.
World J Surg Oncol
; 22(1): 5, 2024 Jan 03.
Article
in En
| MEDLINE
| ID: mdl-38167037
ABSTRACT
BACKGROUND:
The histological subtype is an important prognostic factor for ampulla of Vater (AoV) cancer. This study proposes a classification system for the histological subtyping of AoV cancer based on immunohistochemical (IHC) staining and its prognostic significance.METHODS:
Seventy-five AoV cancers were analyzed for cytokeratin 7 (CK7), CK20, and causal-type homeobox transcription factor 2 (CDX2) expression by IHC staining. We differentiated the subtypes (INT, intestinal; PB, pancreatobiliary; MIX, mixed; NOS, not otherwise specified) into classification I CK7/CK20, classification II CK7/CK20 or CDX2, classification III CK7/CDX2 and examined their associations with clinicopathological factors.RESULTS:
Classifications I, II, and III subtypes were INT (7, 10, and 10 cases), PB (43, 37, and 38 cases), MIX (13, 19, and 18 cases), and NOS (12, 9, and 9 cases). Significant differences in disease-free survival among the subtypes were observed in classifications II and III using CDX2; the PB and NOS subtype exhibited shorter survival time compared with INT subtype. In classification III, an association was revealed between advanced T/N stage, poor differentiation, lymphovascular invasion (LVI), the PB and NOS subtypes, and recurrence risk. In classification III, the subtypes differed significantly in T/N stage and LVI. Patients with the PB subtype had advanced T and N stages and a higher incidence of LVI.CONCLUSIONS:
Classification using CDX2 revealed subtypes with distinct prognostic significance. Combining CK7 and CDX2 or adding CDX2 to CK7/CK20 is useful for distinguishing subtypes, predicting disease outcomes, and impacting the clinical management of patients with AoV cancer.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ampulla of Vater
/
Adenocarcinoma
/
Common Bile Duct Neoplasms
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
World J Surg Oncol
Year:
2024
Document type:
Article
Affiliation country:
South Korea