Can we classify ampullary tumours better? Clinical, pathological and molecular features. Results of an AGEO study.
作者： Geraldine Perkins , Magali Svrcek , Cecile Bouchet-Doumenq , Thibault Voron , Orianne Colussi
DOI: 10.1038/S41416-019-0415-8
关键词: KRAS 、 Multivariate analysis 、 Gastroenterology 、 Pathological 、 MUC1 、 Ampulla of Vater 、 Medicine 、 Immunohistochemistry 、 Cohort 、 Internal medicine 、 Retrospective cohort study
摘要: Ampullary adenocarcinoma (AA) originates from either intestinal (INT) or pancreaticobiliary (PB) epithelium. Different prognostic factors of recurrence have been identified in previous studies. In 91 AA patients the AGEO retrospective multicentre cohort, we evaluated centrally reviewed morphological classification, panel markers Ang et al. including CK7, CK20, MUC1, MUC2 and CDX2, 50-gene mutational analysis, clinicopathological score. Forty-three (47%) tumours were Ang-INT, 29 (32%) Ang-PB, 18 (20%) ambiguous (Ang-AMB) one could not be classified. Among these 90 tumours, 68.7% INT Ang-INT 78.2% PB Ang-PB. MUC5AC expression was detected 32.5% 86 evaluable cases. 71 KRAS, TP53, APC PIK3CA most frequently mutated genes. The KRAS mutation significantly more frequent subtype. multivariate only score tumour subtype associated with relapse-free survival. Only overall Mutational analysis provide no additional value evaluation patients. classification confirmed as a strong prognosticator for disease recurrence.
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