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ObjectiveTo study the expressions of Survivin and Bcl-2 in carcinoma of the ampulla of Vater and their clinical significance.Methods The expressions of Survivin and Bcl-2 proteins were tested by EnVision immunohistochemistry in 40 cases of ampullary carcinomas,and 8 cases of normal ampulla of rater as control.ResultsThe positive expression of Survivin and Bcl-2 in the tissues from the ampullary carcinoma was significantly higher than that in the normal controls(82.5％,72.5％ vs 0％,12.5％,P ＜0.05).The expression of Survivin and Bcl-2 had no relations with the sex,age,tumor size,histological types,and clinical stages( P ＞ 0.05 ).The differences of the expression of Survivin and Bcl-2 in ampullary carcinoma of duodenal invasion,pancreatic invasion,and lymph node metastasis were significant(P ＜ 0.05) ; Significantly positive correlation was found between the expression of Survivin and Bcl-2 by using spearman correlation analysis( r =0.647,P ＜ 0.05 ).Conclusions Survivin and Bcl-2 may play an important role in tumorigenesis of ampullary carcinoma.Combined detection of Survivin and Bcl-2 may be useful to determine the degree of malignancy and the progress of the ampullary carcinoma.
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Los tumores de la papila de Vater constituyen tumores de aparición inusual. Su incidencia es menor al 5% de los tumores del tracto gastrointestinal. La edad de aparición es variable siendo mayor entre los 50-70 años, predominando en el sexo masculino. Una incidencia menor lo constituyen los tumores neuroendocrinos de la ampolla, los cuales tienen aproximadamente 105 casos como reporte en la literatura mundial. Presentamos a un paciente masculino de 53 años de edad, quien consulta por pérdida de peso, dolor abdominal, ictericia obstructiva. Ultrasónido Abdominal y TAC abdomino pelvica: Hepatomegalia. LOEs hepáticos. Barro vesicular. Dilatación de vías biliares intra y extrahepáticas, LOE de cabeza de pancreas. Se le realiza duodeno pancreatectomia de Whipple con hemorragia digestiva a repetición. El estudio histológico mostró un carcinoma neuroendocrino de la papila duodenal, tipo I (epitelial) grado III.
Tumors of the papilla are unusual entities. The incidence is less than 5 % of all new digestive tract neoplasms. It may occur in all age groups, but they are more prevalent in people aged 50-70 years, a slight male predominance. Endocrine neoplasms have a less incidence and only 105 cases are reported in the literature. A case of a 53-year-old male with weight loss, abdominal pain, obstructive jaundice is reported. Abdominal ultrasonography showed hepatomegaly, hepatic lesions, biliary sludge, and pancreatic lesion with intra-extra hepatic biliary tract dilatation. He had a successive upper digestive bleeding, pancreaticoduodenectomy was performed. Histological evaluation showed neuroendocrine carcinoma of the ampulla of Vater, Type I (epithelial) Grade III.
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PURPOSE: The prognostic factors for carcinoma of the Ampulla of Vater have not been fully identified. This study was undertaken in order to determine whether or not immunohistochemical staining can be used identify the potential diagnostic and prognostic markers for carcinoma of the Ampulla of Vater. METHODS: We studied twenty four patients with carcinoma of the Ampulla of Vater who underwent curative resection from September 1995 to February 2003 at the Department of Surgery, Dong-A University Medical Center. All the specimens were reviewed by an expert pathologist, and immunohistochemical stains were used to differentiate the pathologic type. RESULTS: The overall 5-year survival rate was 58.3%, and survival was closely correlated with the pathologic differentiation. For the immunohistochemical stains, CK20 and MUC2 were significantly effective to differentiate the intestinal type and the pancreaticobiliary type of carcinoma for the Ampulla of Vater (P=0.0162 and P=0.0001, respectively). CONCLUSION: Further investigations with a larger number of cases would enable us to use immunohistochemical stains to improve the differentiation of carcinoma of the Ampulla of Vater.