Document Detail


Ampullary carcinoma: prognostic significance of ploidy, cell-cycle analysis and proliferating cell nuclear antigen (PCNA).
MedLine Citation:
PMID:  10370689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The aim of the present study is to assess the nuclear DNA ploidy patterns, the fraction of cells in the various phases of the cell cycle as determined by flow cytometry and to evaluate Proliferative cell-nuclear antigen (PCNA) expression in order to examine the relationships between phase-two molecular factors, clinicopathological aspects and outcome of patients with cancers of the ampulla of Vater. METHODOLOGY: Paraffin-embedded specimens from 18 cases of cancers of ampulla of Vater radically resected between 1985 and 1995 were analyzed by flow-cytometry and immunohistochemical staining with monoclonal antibody to the PCNA. The relationships between cell-proliferation kinetics, PCNA-positive cancer cells, clinicopathological findings and the clinical course were evaluated. RESULTS: Pathologist reports documented 17 papillary adenocarcinomas and one case of mucinous carcinoma. According to the TNM classification, 4 patients were in stage I, 7 in stage II and 7 in stage III. Locally advanced ampullary tumors (T3-T4) had a significantly worse prognosis (p = 0.01); survival at 3 and 5 years for stage I-II patients (11 cases) was 90% and 79% as compared to 42% and 42% for patients with stage III (8 cases), respectively (p = n.s.). Thirteen cancers (72%) were diploid and 5 (28%) aneuploid. Patients with aneuploid tumors were younger (mean age: 59 years) than patients with diploid tumors (mean age: 66 years; p = 0.04). No significant correlation was found between size of the tumor (T), lymphnodal status (N), grading (G) or aneuploidy. Difference in terms of survival between aneuploid and diploid patients was relevant (16 vs. 121 months) but, due to the small number of cases, was not statistically significant (p = n.s). The mean value of S-phase fraction (SPF) was 14.8%. PCNA positive rate significantly correlates with size of the tumor (T1-T2 vs. T3-T4; p = 0.03). Actuarial overall survival resulted in 70%, 63% and 31% at 1, 5 and 10 years, respectively. The high rate of diploidy (72%) supports the relative benign behavior of ampullary cancers. CONCLUSIONS: PCNA positive rate significantly correlates with size of the disease. Aneuploidy, although without significant prognostic value, correlates well with survival. Because of the wide range of all variables, more data are needed to establish the relationships between pathological factors, DNA ploidy and PCNA rate and their significance as molecular predictors of prognosis in ampulla of Vater cancers.
Authors:
A Crucitti; R Masetti; C Breccia; R Coppola; P Magistrelli; G Nuzzo; N Maggiano; A Picciocchi
Related Documents :
8024109 - Basaloid squamous cell carcinoma of the head and neck: a clinicopathologic and flow cyt...
9015179 - Prognostic value of flow cytometric dna analysis in non-small-cell lung cancer: rationa...
18182669 - Long-term results of the aieop-all-95 trial for childhood acute lymphoblastic leukemia:...
11428449 - Presence of epstein-barr virus latent membrane protein 1 gene in the nasopharyngeal swa...
9428479 - Prognostic significance of dna ploidy in patients with stage ii and stage iii colon car...
10362089 - Prognostic factors in retroperitoneal sarcomas: ploidy of dna as a predictor of clinica...
16434629 - Frequency and effect of adjuvant radiation therapy among women with stage i endometrial...
7294929 - Axillary micro- and macrometastases in breast cancer: prognostic significance of tumor ...
21289369 - Comparison of recist and choi criteria for computed tomographic response evaluation in ...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  46     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    1999 Mar-Apr
Date Detail:
Created Date:  1999-08-13     Completed Date:  1999-08-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  GREECE    
Other Details:
Languages:  eng     Pagination:  1187-91     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Catholic University of the Sacred Heart, Rome, Italy. surgcic@mbox.vol.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ampulla of Vater / pathology*,  surgery
Cell Cycle / physiology*
Common Bile Duct Neoplasms / mortality,  pathology*,  surgery
Female
Flow Cytometry
Humans
Male
Middle Aged
Neoplasm Staging
Ploidies*
Prognosis
Proliferating Cell Nuclear Antigen / analysis*
Survival Rate
Treatment Outcome
Tumor Markers, Biological / analysis*
Chemical
Reg. No./Substance:
0/Proliferating Cell Nuclear Antigen; 0/Tumor Markers, Biological

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Pathophysiology after pylorus-preserving pancreatoduodenectomy: a comparative study of pancreatogast...
Next Document:  Three generations of hereditary chronic pancreatitis.