Pancreatoduodenal carcinoma: a clinicopathologic study of 304 patients and immunohistochemical observation for CEA and CA19-9

摘要: A total of 304 patients with pancreatoduodenal carcinoma were studied clinicopathologically and immunohistochemically in order to clarify features four different sites origin; the ampulla Vater (Am), distal common bile duct (DCBD), head pancreas (PH), extra-ampullary duodenum (Du). The mean greatest diameter 87 PH was 3.5 cm compared 2.7 149 Am DCBD. Histopathologically, 40% papillary adenocarcinoma, while about half DCBD, Du tubular adenocarcinoma. invaded lymphatic (85%), vascular (62%), perineural (95%) spaces metastasized lymph nodes (72%) more frequently than (77%, 35%, 24%, 50%), DCBD (47%, 61%, 65%, 45%), (76%, 29%, 65%), respectively. More 50% resected margins, whereas only 2% Am, surgical margins affected by malignant cells. Immunohistochemically, positive for both carcinoembryonic antigen (CEA) (98%) carbohydrate (CA) 19-9 (91%) (83%, 62%), (94%, 58%), (56%, 11%), stromal staining type CEA CA seen (27%, 44%) (9%, 31%), (11%, 8%) (0%, 0%), showing a dedifferentiated nature PH. cumulative 3-year survival rate (15%) worse that (42%, P less 0.001), 51 (25%) 17 (58%, 0.001). curve (P 0.001) Cox regression analysis, using eleven profound prognostic variables, revealed venous invasion, infiltration, margin, histopathologic factors. Pancreatic has nature, aggressive growth fares Du.