Correlation of Ki-67, nm23-H1 and the VEGF Expression with the Clinicopathological Variables for Distant Recurrence after Curative Surgery for Carcinoma of the Ampulla of Vater.
- Author:
Sungho JO
1
;
Jin Seok HEO
;
Seong Ho CHOI
;
Kee Taek JANG
;
Mi Jung OH
;
Dong Wook CHOI
;
Jun Chul CHUNG
;
Sung Gyu LEE
;
Yong Il KIM
Author Information
1. Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea. jinseok.heo@samsung.com
- Publication Type:Original Article
- Keywords:
Ampulla of Vater carcinoma;
Curative resection;
Distant recurrence;
Ki-67 labeling index;
Lymph node metastasis
- MeSH:
Ampulla of Vater*;
Humans;
Ki-67 Antigen;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Population Characteristics;
Recurrence*;
Retrospective Studies;
Vascular Endothelial Growth Factor A*
- From:Journal of the Korean Surgical Society
2006;71(2):119-127
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Not a few patients show early distant recurrence after curative resection for carcinoma of the ampulla of Vater, and this recurrence is not just related to the clinicopathological factors. This study was performed to determine the correlation of the clinicopathological and biological characteristics with early distant recurrence after surgery for carcinoma of the ampulla of Vater. METHODS: Of the 158 patients who underwent curative resection for carcinoma of the ampulla of Vater at the Samsung Medical Center between December 1994 and August 2004, 38 patients (the recurrence group) with distant recurrence within a year after surgery and 32 patients (the non-recurrence group) without recurrence for more than 3 years after surgery were retrospectively analyzed. Evaluation of their clinicopathological characteristics and their immunohistochemical staining for Ki-67 antigen, nm23-H1 protein and vascular endothelial growth factor (VEGF) were carried out. RESULTS: Of the recurrence group, 24 patients (63.2%) had multiple recurrence sites and 10 (26.3%) were TNM stage I after surgery. The TNM stage was significantly advanced in the recurrence group. Both the Ki-67 labeling index (LI) (10.2% vs. 5.8%, respectively) and positive rate (50.0% vs.18.8%, respectively) according to the cut-off value of Ki-67 LI (i.e. 9%) were significantly higher in the recurrence group. The immunoreactivity for nm23-H1 protein and VEGF was not different between the two groups. Only lymph node metastasis was statistically significant on the multivariate analysis for early distant recurrence after surgery. CONCLUSION: The recurrence group showed an advanced TNM stage and increased Ki-67 LI. Lymph node metastasis was the single independent poor indicator for early distant recurrence after curative resection for carcinoma of the ampulla of Vater.
