ABSTRACT
OBJECTIVES: This study aimed to compare the intestinal and pancreatobiliary subtypes of ampullary adenocarcinoma in a large patient group due to limited data on survival and risk factors. METHODS: A retrospective analysis of the clinical and pathological findings and the survival of 184 patients with ampullary adenocarcinoma who underwent curative operation between 2007 and 2018 was performed. RESULTS: Pancreatobiliary subtype had a higher prevalence of jaundice before operation than the intestinal subtype (p < 0.05). Pancreatobiliary subtype had a larger tumor size (> 2 mm) (p < 0.01) and poorer differentiation (p < 0.05) than the intestinal subtype. Perineural invasion more frequently occurred in pancreatobiliary subtype than the intestinal subtype (p < 0.01) and pancreatobiliary subtype had a higher prevalence of positive dissected lymph nodes (p < 0.05) with an advanced disease stage (p < 0.01) than the intestinal subtype. Patients of the pancreatobiliary subtype had poorer disease-free and overall survival than patients of the intestinal subtype. No survival benefit of adjuvant chemotherapy was found in either patients of the intestinal subtype or pancreatobiliary subtype. No significant difference was found in any subtypes regarding the recurrent regions. CONCLUSIONS: Pancreatobiliary subtype exhibited a higher recurrence rate and a poorer overall survival rate with more unfavorable pathological characteristics than the intestinal subtype.
OBJETIVOS: Los datos sobre la supervivencia y los factores de riesgo del adenocarcinoma ampular son limitados debido a su rareza. Este estudio buscó comparar el subtipo intestinal y el subtipo pancreático-biliar en pacientes con adenocarcinoma ampular. MÉTODOS: Análisis retrospectivo de hallazgos clínicos y patológicos y la supervivencia de 184 pacientes con adenocarcinoma ampular tratados entre 2007 y 2018. RESULTADOS: El subtipo pancreático-biliar tuvo una mayor prevalencia de ictericia antes de la operación y un tamaño de tumor mayor, y una peor diferenciación, que el subtipo intestinal. La invasión perineural fue más frecuente en el subtipo pancreático-biliar, con una mayor prevalencia de linfonodos disecados positivos y un estadio avanzado de la enfermedad. Los pacientes del subtipo pancreático-biliar tuvieron una supervivencia libre de enfermedad y una supervivencia general peores que los pacientes del subtipo intestinal. No se encontró ningún beneficio de la quimioterapia adyuvante en pacientes del subtipo intestinal o pancreático-biliar. No hubo diferencia significativa en las regiones recurrentes. CONCLUSIÓN: El subtipo pancreático-biliar mostró una tasa de recurrencia y una tasa de supervivencia general peores, con características patológicas más desfavorables que el subtipo intestinal.
Subject(s)
Adenocarcinoma , Ampulla of Vater , Common Bile Duct Neoplasms , Humans , Retrospective Studies , Ampulla of Vater/pathology , Male , Female , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adenocarcinoma/mortality , Adenocarcinoma/classification , Common Bile Duct Neoplasms/pathology , Common Bile Duct Neoplasms/surgery , Common Bile Duct Neoplasms/mortality , Common Bile Duct Neoplasms/classification , Middle Aged , Aged , Chemotherapy, Adjuvant , Adult , Neoplasm Invasiveness , Aged, 80 and over , Neoplasm Recurrence, Local , Lymphatic Metastasis , Tumor Burden , Disease-Free SurvivalABSTRACT
A rapid and accurate size-exclusion HPLC method for the quantitation of polysorbate 80 (PS80) in Houttuynia cordata injection, a Chinese traditional medicine, was developed and validated. The assay was conducted on an Agilent 1100 HPLC system with a TosoHaas TSKgel G2000 SWxL column (30 cm x 7.8 mm, 5 pm particle size) and an Alltech evaporative light-scattering detector (ELSD) 2000. The mobile phase was 20 mmoL/L ammonium acetate-acetonitrile (90 + 10, v/v) delivered at a flow rate of 0.6 mL/min under isocratic conditions. The ELSD was operated in the impactor "off" mode, the drift tube temperature was set at 110 degrees C, and nitrogen flow was maintained at 2.3 L/min. The LOD was 0.25 mg/mL. Linearity was obtained between the log of concentration (C) and the log of peak area (Y) of PS80 in the range of 0.5-20 mg/mL according to the equation: Log Y 1.4529 Log C - 0.8232 (r2 = 0.9976). An RSD of 1.6% (n = 6) for the determination demonstrated the good precision of the optimized method. PS80 content in several commercial H. cordata injection products from different manufacturers was determined. The data for PS80 content is useful in evaluation of the safety of the products from different manufacturers.
