Hashmi Atif A, Ali Ramla, Jamal Syed Sualeh, Zafar Sumbal, Zia Shamail, Zia Fazail, Anjali Fnu, Kirshan Kumar Sanjay, Irfan Muhammad
Pathology, Liaquat National Hospital and Medical College, Karachi, PAK.
Internal Medicine, Liaquat National Hospital and Medical College, Karachi, PAK.
Cureus. 2024 Aug 16;16(8):e67030. doi: 10.7759/cureus.67030. eCollection 2024 Aug.
Introduction The ampulla of Vater is a structure in the duodenal wall in which the biliary and pancreatic ducts open. Malignant epithelial tumors arising at this site are commonly referred to as ampullary adenocarcinomas. In this study, we compared the clinicopathological features of intra-ampullary and periampullary carcinomas, including survival outcomes. Methods This retrospective cross-sectional study was conducted at the Department of Pathology, Liaquat National Hospital. All radiologically suspected cases or biopsy-proven (endoscopic biopsy) cases of intra-ampullary/periampullary carcinoma were included in the study. All patients underwent surgical resection (Whipple's procedure/pancreatoduodenectomy). The classification of intra-ampullary and periampullary carcinomas was performed according to the College of American Pathologists (CAP) guidelines. Results Among the 188 case studies, most (61.7%, n = 116) were males, with a median age of 55 years. Most tumors were of the pancreatobiliary subtype (57.4%, n = 108). Similarly, intra-ampullary carcinoma was more common than periampullary carcinoma (61.7% vs. 38.3%). Intra-ampullary carcinoma showed a higher extent of involvement of adjacent structures, a higher frequency of perineural invasion, and a higher nodal stage than periampullary carcinoma. Similarly, the median disease-specific survival of intra-ampullary carcinoma was significantly lower (46 months) than that of periampullary carcinoma (53.5 months). Conclusion We found a higher incidence of intra-ampullary carcinoma in our study. In addition, intra-ampullary carcinoma had a worse survival rate and was associated with poorer pathological parameters, such as perineural invasion and higher nodal and tumor stages than periampullary carcinoma.
引言 Vater壶腹是十二指肠壁上的一个结构，胆管和胰管在此处开口。起源于该部位的恶性上皮性肿瘤通常被称为壶腹腺癌。在本研究中，我们比较了壶腹内癌和壶腹周围癌的临床病理特征，包括生存结果。
方法 本回顾性横断面研究在利亚卡特国家医院病理科进行。所有经影像学怀疑或活检证实（内镜活检）的壶腹内/壶腹周围癌病例均纳入研究。所有患者均接受了手术切除（Whipple手术/胰十二指肠切除术）。壶腹内癌和壶腹周围癌的分类按照美国病理学家学会（CAP）指南进行。
结果 在188例病例研究中，大多数（61.7%，n = 116）为男性，中位年龄为55岁。大多数肿瘤为胰胆管亚型（57.4%，n = 108）。同样，壶腹内癌比壶腹周围癌更常见（61.7%对38.3%）。与壶腹周围癌相比，壶腹内癌显示出更高的相邻结构受累程度、更高的神经周围侵犯频率和更高的淋巴结分期。同样，壶腹内癌的中位疾病特异性生存期（46个月）显著低于壶腹周围癌（53.5个月）。
结论 我们在研究中发现壶腹内癌的发病率较高。此外，壶腹内癌的生存率较差，并且与较差的病理参数相关，如神经周围侵犯以及比壶腹周围癌更高的淋巴结和肿瘤分期。
