Immunohistochemical Predictors for Intestinal and Pancreatobiliary Types of Adenocarcinoma of The Ampulla of Vater

Santos, João Paulo Lemos da Silveira; Machado, Carla Jorge; Paulino, Eduardo; Rodrigues, João Bernardo Sancio Rocha; Vidigal, P.T.; Resende, Vívian

doi:10.1007/s11605-018-3797-7

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…Among the periampular carcinomas, the ductal adenocarcinoma of the head of the pancreas (ADCP) has the worst prognosis. The survival of patients undergoing surgical interventions approximates that observed in patients with neoplasia of the papilla or distal choledochus, and belong to the pancreatobiliary subtype 10,11 .…”

Section: Fatores Prognósticos Pré-operatórios Em Pacientes Com Adenoc...mentioning

confidence: 82%

Fatores prognósticos pré-operatórios em pacientes com adenocarcinoma ductal da cabeça do pâncreas

Sancio

Campanati

Lima

et al. 2020

Rev. Col. Bras. Cir.

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RESUMO Objetivos: Identificar fatores prognósticos pré-operatórios relacionados à sobrevida de pacientes com adenocarcinoma ductal da cabeça de pâncreas (ADCP) submetidos a tratamento cirúrgico com intenção curativa em uma única instituição brasileira. Método: No período de 2005 a 2018, dados clinicodemográficos e laboratoriais pré-operatórios foram prospectivamente coletados. A análise de sobrevida foi feita pelo método de Kaplan-Meier e a comparação entre as curvas pelo teste de log-rank. Para a análise multivariada utilizou-se o modelo de regressão de Cox. Resultados: Os fatores pré-operatórios com impacto significativo na sobrevida à análise univariada foram a idade maior ou igual a 70 anos (p=0,012) e história pessoal prévia positiva para câncer (p=0,026). A análise multivariada, pacientes com níveis séricos pré-operatórios de CA 19.9 de 38 a 554 U/ml apresentaram 3,15 vezes maior chance de óbito (HR 3,15; IC 95% 1,01 - 9,82; p=0,047), enquanto que os pacientes com o marcador acima de 554 U/ml evoluíram com chance 3,96 vezes maior de óbito que aqueles com a dosagem normal (HR 3,96; IC 95% 1,19 - 13,10; p=0,024). Pacientes com comorbidades prévias evoluíram com chance 2,90 vezes superior de óbito que doentes sem condições associadas (HR 2,90; IC 95% 1,10 - 7,67; p=0,032). Conclusão: O ADCP mostrou ser doença agressiva para a qual os fatores pré-operatórios de pior prognóstico foram idade avançada, presença de comorbidades, história prévia de câncer e nível sérico de CA 19.9 elevado no pré-operatório.

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Section: Fatores Prognósticos Pré-operatórios Em Pacientes Com Adenoc...mentioning

confidence: 82%

Fatores prognósticos pré-operatórios em pacientes com adenocarcinoma ductal da cabeça do pâncreas

Sancio

Campanati

Lima

et al. 2020

Rev. Col. Bras. Cir.

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“…On the other hand, CK7 is more often expressed by the pancreatobiliary subtype [ 17 ]. A recent study in 30 patients, identified CK7 and CDX2 as the 2 most discriminating immunohistochemical markers for the distinction between pancreatobiliary subtype and intestinal subtype [ 18 ]. Mucins are high-molecular-weight glycoproteins expressed by epithelial tissues.…”

Section: Discussionmentioning

confidence: 99%

The use of histopathological subtyping in patients with ampullary cancer: a nationwide analysis

et al. 2022

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Background Recent guidelines advise to subtype adenocarcinoma at the ampulla and papilla of Vater (here: ampullary cancer) as intestinal, pancreatobiliary, and mixed, because this has consequences for both prognosis and treatment. This nationwide study aimed to investigate how often histopathological subtyping is performed in daily clinical practice in patients with ampullary cancer. Methods Pathology reports of all patients with ampullary cancer were retrieved from the Dutch nationwide pathology database (PALGA, 1991-2020). Reports were assessed for the presence and methods used for the classification of these tumors into intestinal, pancreatobiliary, and mixed subtypes. The use of immunohistochemical markers was recorded. Results Overall, 5246 patients with ampullary cancer were included. In 1030 (19.6%) patients, a distinction between intestinal, pancreatobiliary, and mixed subtypes was made. Use of subtyping increased from 3% in 1991–1993 to 37% in 2018–2020. In 274 of the 1030 (26.6%) patients, immunohistochemistry was used to make this distinction. A gradual increase in the use of various immunohistochemical markers was seen over time since 2008, with cytokeratin 7, cytokeratin 20, and CDX2 being the most common. Staining of DPC4/SMAD4 was increasingly used since 2012. Conclusion Despite recent improvements in the use of subtyping in ampullary cancer, the distinction between intestinal, pancreatobiliary, and mixed subtypes is only made in a minority of patients. Nationwide efforts are required to standardize the pathological distinction of the various subtypes of ampullary cancer.

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“…The ductal adenocarcinoma of the head of the pancreas (DAHP) presents itself to be the most aggressive tumor of his class with worse clinical prognosis. The Ductal adenocarcinoma of the head of the pancreas shows the extremely aggressive disease, with the worst prognostic factors being old age, presence of comorbidities, previous history of cancer and complications in the postoperative period [3].…”

Section: Discussionmentioning

confidence: 99%

“…The addition of modern diagnosis methods associated to the improvement of the other methods that already exist has given rise to controversy regarding to the best way of diagnosing and tumor staging. Likewise, the role of surgery in palliation and technical aspects of the located injuries resection are far from reaching consensus on practice [3,4].…”

Section: Introductionmentioning

confidence: 99%

Tumor in the Pancreatic Head: A Case Report

Santo¹

2020

AJBSR

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Immunohistochemical Predictors for Intestinal and Pancreatobiliary Types of Adenocarcinoma of The Ampulla of Vater

Abstract: CDX2 and CK7 were the immunohistochemical markers that best discriminated the intestinal from the pancreatobiliary type. Lymph node involvement had a high impact on survival and proved to be more frequent in the pancreatobiliary type.

Cited by 5 publications

References 31 publications

Fatores prognósticos pré-operatórios em pacientes com adenocarcinoma ductal da cabeça do pâncreas

Fatores prognósticos pré-operatórios em pacientes com adenocarcinoma ductal da cabeça do pâncreas

The use of histopathological subtyping in patients with ampullary cancer: a nationwide analysis

Tumor in the Pancreatic Head: A Case Report

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