Mucins Differently Expressed in Various Ampullary Adenocarcinomas

Wang, Tao; Liang, Yong; Hu, Peng; Cheng, Yu

doi:10.1186/1746-1596-6-102

Cited by 10 publications

(11 citation statements)

References 25 publications

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“…It has however previous been shown that the morphological distinction between intestinal and pancreatobiliary morphology has prognostic implications, not only in ampullary adenocarcinomas, but in all periampullary adenocarcinomas, regardless of tumour origin [ 14 ]. Moreover, while differences in the expression of cytokeratins and mucins according to morphology have been observed in ampullary carcinomas [ 15 ], these differences seem to be less evident in series stratified solely by the anatomical centre of the ampullary adenocarcinomas [ 16 ]. These findings suggest that morphological and molecular tumour characteristics have a greater prognostic impact than the appreciated tumour origin.…”

Section: Discussionmentioning

confidence: 99%

Use of a standardized diagnostic approach improves the prognostic information of histopathologic factors in pancreatic and periampullary adenocarcinoma

Elebro

Jirström

2014

Diagn Pathol

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BackgroundVariability in reported histopathology parameters in operated periampullary adenocarcinomas may affect the prognostic weight of the parameters. Standardized axial sectioning produces a higher incidence of involved margins and also seems to produce a lower relative incidence of pancreatic compared with distal bile duct origin and a higher incidence of involved lymph nodes, compared with non-standardized procedure. The aims of this study were to 1) assess how a previously not described standardized pathology procedure, with longitudinal sectioning along the distal bile duct, affects reported tumour origin, margin status and involved lymph nodes, compared with non-standardized procedure, 2) assess if re-evaluation of microscopic slides affects the prognostic value of margin status and 3) compare the results of this standardized procedure with reported results of other standardized and non-standardized procedures.MethodsOne hundred seventy-five consecutive pancreaticoduodenectomy specimens with primary adenocarcinomas, operated during 2001 – 2011 at the University hospitals of Lund and Malmö, Sweden, were re-evaluated histologically, and parameters relevant for classification and prognosis were assessed, with 1 mm as a threshold for involved or uninvolved margins. Follow-up lasted until 31 December 2013. Five-year overall survival (OS) and hazard ratios (HR) were calculated for the margin status stated in the original reports and margin status after re-evaluation.ResultsCompared with non-standardized cases (n = 129), standardized cases (n = 46) had more involved lymph nodes in the specimens (median 3 vs 1), a higher fraction of distal bile duct origin (39% vs 21%) and a higher fraction of involved margins (74% vs 47%). The prognostic value of uninvolved margins increased by re-evaluation of slides (p < 0.001) and the adjusted HR for involved margins increased from 1.6 (95% CI 1.1 - 2.4) to 3.3 (95% CI 1.5 – 7.0). Uninvolved margins remained a significant predictor of OS in adjusted analysis.ConclusionsBoth the method of sectioning the specimen and the microscopic assessment affect prognostic pathology parameters significantly. The results of the herein described standardized method are similar to the results of other standardized procedures. The 1-mm threshold for involved margins in pancreaticoduodenectomies is relevant for OS, and margin status is an independent prognostic parameter.Virtual slidesThe virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1056639379120615

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Section: Discussionmentioning

confidence: 99%

Use of a standardized diagnostic approach improves the prognostic information of histopathologic factors in pancreatic and periampullary adenocarcinoma

Elebro

Jirström

2014

Diagn Pathol

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“…The expression of MUC1 is related to poor prognosis in pancreatobiliary pancreatic head tumors. The expression of MUC5AC is associated with good prognosis and little vascular invasion of PDAC [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Levels of HOXB7 and miR-337 in pancreatic ductal adenocarcinoma patients

Zhang

Zheng

et al. 2014

Diagn Pathol

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BackgroundMany studies have revealed that homeobox-B7 (HOXB7) and miR-337 play important roles in different types of human cancers. However, the relationship of HOXB7 and miR-337 in PDAC with clinicopathological factors has not yet been examined and their biological roles remain to be explored.MethodsUsing quantitative real-time RT-PCR and immunohistochemical staining, the expression of HOXB7 mRNA, miR-337, and HOXB7 protein in 44 PDAC samples was detected. Survival curves were made using follow-up data. The relationship between clinical or pathological characteristics and the prognosis was analyzed.ResultsThe expression levels of HOXB7 mRNA and HOXB7 protein were significantly elevated in PDAC samples than that in non-malignant adjacent tissues. There were obvious differences in HOXB7 mRNA and proteins between tumors of different diameters, differentiation, TNM stage, and lymph node status. The level of miR-337 was markedly lower in tumor samples than in non-malignant adjacent tissues. The expression of miR-337 was related to TNM stage and lymph node status. There were significant differences in survival curves between patients with tumors <4 cm in diameter and patients with tumors ≥4 cm, among groups of well, moderately, and poorly differentiated tumors, between groups with TNM stages I, II and III or IV, between groups with metastatic lymph nodes and non-metastatic lymph nodes, among groups of HOXB7 protein expression negative (or weak) and positive, between groups with low levels of miR-337 expression and with high levels of miR-337 expression. The levels of HOXB7 mRNA, HOXB7 protein, and miR-337 were found to be associated with longer survival.ConclusionThe present study showed that HOXB7 was over-expressed and miR-337 was minimally expressed in PDAC tissues, and their levels were related to TNM stage and lymph node status. The levels of HOXB7 mRNA, HOXB7 protein, and miR-337 were associated with survival in PDAC patients. Results suggested that HOXB7 and miR-337 could be used as determinants of PDAC patient prognosis.Virtual slidesThe virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1509730773118658.

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“…Mucins and CDX2 are useful markers for diagnosing ampullary adenocarcinoma and particularly for determining the degree of malignancy (12). Most intestinal-type ampullary cancers express CDX2 and MUC2, whereas pancreatobiliary subtype papillae are, at least focally, positive for MUC5AC, and gastric-tubular subtype papillae are, at least focally, positive for MUC1 (3,11,13).…”

Section: Discussionmentioning

confidence: 99%

“…MUC5AC in our case was positive in only part of the duodenal epithelium, not the site of adenocarcinoma in situ , as we assume our case was an intraepithelial cancer, not an advanced ampullary adenocarcinoma. Patients with ampullary adenocarcinoma positive for MUC5AC have a worse survival than those negative for MUC5AC (12,13).…”

Section: Discussionmentioning

confidence: 99%

Laterally Spreading Adenocarcinoma Involving the Lower Bile Duct and Duodenum Expressing Heterogeneous Immunohistochemical Phenotypes

et al. 2019

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A 70-year-old man was admitted to our hospital due to elevated levels of hepatobiliary and pancreatic enzymes. Computed tomography showed contrast-enhanced mucosal hypertrophy from the duodenal papilla to the distal bile duct. Endoscopic examinations revealed a laterally spreading granular tumor and ampullary swelling. After surgical resection, an examination revealed well-differentiated adenocarcinoma of the ampulla with tubular adenoma spreading from the distal common bile duct to the second part of the duodenum showing both bile duct and duodenal phenotypes. To our knowledge, this is the first case of a tumor spreading from the bile duct to the duodenum that exhibited multiple phenotypes.

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Mucins Differently Expressed in Various Ampullary Adenocarcinomas

Cited by 10 publications

References 25 publications

Use of a standardized diagnostic approach improves the prognostic information of histopathologic factors in pancreatic and periampullary adenocarcinoma

Use of a standardized diagnostic approach improves the prognostic information of histopathologic factors in pancreatic and periampullary adenocarcinoma

Levels of HOXB7 and miR-337 in pancreatic ductal adenocarcinoma patients

Laterally Spreading Adenocarcinoma Involving the Lower Bile Duct and Duodenum Expressing Heterogeneous Immunohistochemical Phenotypes

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