Isozaki H, Okajima K, Ichinona T, Tanimura M, Morita S, Takada Y, Ishibashi T, Hara H
Department of General and Gastroenterological Surgery, Osaka Medical College, Japan.
Surg Today. 1994;24(6):494-9. doi: 10.1007/BF01884567.
Seventeen patients with cancer of the ampulla of Vater were studied retrospectively using immunohistochemical staining with a monoclonal antibody to the proliferating cell nuclear antigen (PCNA). The relationships between the PCNA-positive rate, being the number of PCNA-positive cancer cells to total cancer cells, the clinicopathological findings, and the clinical course were evaluated. The PCNA-positive rate in patients with lymph node metastasis (47%) was significantly higher than that in patients without metastasis (29%), while that in patients with advanced cancer invading the pancreatic parenchyma (47%), was significantly higher than that in patients with early cancer without invasion of the sphincter of Oddi (32%). All of five patients with early cancer are still alive, whereas five with semi-advanced cancer invading the sphincter of Oddi but not the pancreatic parenchyma, and two with a PCNA-positive rate of over 40% died of recurrent cancer. Of seven patients with advanced cancer, only one with a low PCNA-positive rate of 23% is alive, but the other six with a PCNA-positive rate of over 40% all died. The results suggest that the PCNA-positive rate provides a prognostic index for cancer of the ampulla of Vater.
采用抗增殖细胞核抗原（PCNA）单克隆抗体免疫组化染色法，对17例 Vater壶腹癌患者进行回顾性研究。评估PCNA阳性率（即PCNA阳性癌细胞数与癌细胞总数之比）、临床病理表现及临床病程之间的关系。有淋巴结转移患者的PCNA阳性率（47%）显著高于无转移患者（29%），而侵犯胰腺实质的进展期癌患者的PCNA阳性率（47%）显著高于未侵犯Oddi括约肌的早期癌患者（32%）。5例早期癌患者均存活，而5例侵犯Oddi括约肌但未侵犯胰腺实质的半进展期癌患者以及2例PCNA阳性率超过40%的患者死于复发性癌症。7例进展期癌患者中，只有1例PCNA阳性率低至23%的患者存活，而其他6例PCNA阳性率超过40%的患者均死亡。结果表明，PCNA阳性率可为Vater壶腹癌提供预后指标。
