Identification of ampullary carcinoma mixed subtype using a panel of six antibodies and its clinical significance
Identification of ampullary carcinoma mixed subtype using a panel of six antibodies and its clinical significance
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使用六种抗体鉴定壶腹癌混合亚型及其临床意义。
DOI：
10.1002/jso.25311
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发表时间：
2019-03-01
影响因子：
2.5
通讯作者：
Wang, Hanlin
中科院分区：
文献类型：
--
作者：
Liu, Fangfang;Shen, Danhua;Wang, Hanlin
目的探讨免疫标志物CK 7、CK 20、CK 17、CDX 2、MUC 1、MUC 2在原发性壶腹癌混合亚型鉴别中的作用。方法对42例原发性壶腹癌进行免疫组化研究。采用SPSS16.0统计软件分析混合亚型与其他两种亚型与患者生存数据的相关性。结果42例中12例（28.6%）为混合型，CK 7、CK 20表达率分别为91.7%（11/12）、83.3%（10/12）、66.7%（8/12）、66.7%（8/12），MUC 2表达率为50%（6/12）。10例（83.3%）混合型共表达4种或4种以上免疫标志物。8例（19%）肠道亚型主要表达CK 20、CDX 2和MUC 2。22例（52.4%）胰胆管亚型显示CK 7、MUC 1和CK 17阳性表达。混合亚型（25%）和肠亚型（25%）中的III期和IV期疾病少于胰胆亚型（63.6%）（p = 0.039）。随访数据显示，混合亚型患者的生存率高于胰胆亚型患者。结论免疫组化染色为壶腹混合癌的诊断提供了可靠的方法。壶腹癌的准确分型对选择有效的化疗方案和评估预后具有重要的临床意义。
Objectives To investigate the function of immunomarkers CK7, CK20, CK17, CDX2, MUC1, and MUC2 in the identification of primary ampullary carcinoma mixed subtype. Methods Forty-two cases of primary ampullary carcinoma were performed by immunohistochemical studies. The correlation between the mixed subtype and the other two subtypes and patient survival data was analyzed using the SPSS 16.0 statistical software. Results Among 42 cases, 12 (28.6%) cases were classified as mixed subtype, which showed variable expression patterns: 91.7% (11/12) for CK7, 83.3% (10/12) for CK20; 66.7% (8/12) for CK17, CDX2, and MUC1; and 50% (6/12) for MUC2. Ten (83.3%) mixed types coexpressed four or more immunomarkers. Eight (19%) intestinal subtypes mainly showed a positive expression of CK20, CDX2, and MUC2. Twenty-two (52.4%) pancreaticobiliary subtypes showed a positive expression of CK7, MUC1, and CK17. Stages III and IV diseases in mixed subtype (25%) and intestinal subtype (25%) were less than pancreaticobiliary subtype(63.6%) (p = 0.039). Follow-up data appeared to show a better survival rate for patients with mixed subtype than those with pancreaticobiliary subtypes. Conclusion Immunohistochemical staining provided a more reliable means of diagnosing mixed ampulla carcinoma. Accurate subtyping of ampullary carcinoma is clinically important to select effective chemotherapy regimens and to assess disease prognosis.