Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Institute for Pathology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Sci Rep. 2019 Sep 3;9(1):12676. doi: 10.1038/s41598-019-49179-w.
Ampullary cancer represents approximately 6% of the malignant periampullary tumors. An early occurrence of symptoms leads to a 5-year survival rate after curative surgery of 30 to 67%. In addition to the tumor stage, the immunohistological subtypes appear to be important for postoperative prognosis. The aim of this study was to analyze the different subtypes regarding their prognostic relevance. A total of 170 patients with ampullary cancer were retrospectively analyzed between 1999 until 2016 after pancreatic resection. Patients were grouped according to their pathohistological subtype of ampullary cancer (pancreatobiliary, intestinal, mixed). Characteristics among the groups were analyzed using univariate and multivariate models. Survival probability was analyzed by the Kaplan-Meier method. An exact subtyping was possible in 119 patients. A pancreatobiliary subtype was diagnosed in 69 patients (58%), intestinal in 41 patients (34.5%), and a mixed subtype in 9 patients (7.6%). Survival analysis showed a significantly worse 5-year survival rate for the pancreatobiliary subtype compared with the intestinal subtype (27.5% versus 61%, p < 0.001). The mean overall survival of patients with pancreatobiliary, intestinal, and mixed subtype was 52.5, 115 and 94.7 months, respectively (p < 0.001). The pathohistological subtypes of ampullary cancer allows a prediction of the postoperative prognosis.
壶腹癌占恶性胰周肿瘤的 6%左右。由于症状出现较早，根治性手术后 5 年生存率为 30%至 67%。除肿瘤分期外，免疫组织化学亚型似乎对术后预后也很重要。本研究旨在分析不同亚型的预后相关性。回顾性分析了 1999 年至 2016 年间 170 例经胰腺切除术后的壶腹癌患者。根据壶腹癌的病理组织学亚型（胰胆管型、肠型、混合型）对患者进行分组。使用单变量和多变量模型分析组间特征。采用 Kaplan-Meier 法分析生存概率。119 例患者可进行精确分型。69 例（58%）为胰胆管型，41 例（34.5%）为肠型，9 例（7.6%）为混合型。生存分析显示，胰胆管型与肠型相比，5 年生存率显著降低（27.5%对 61%，p<0.001）。胰胆管型、肠型和混合型患者的平均总生存期分别为 52.5、115 和 94.7 个月（p<0.001）。壶腹癌的病理组织学亚型可预测术后预后。
Zotero 插件