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2011, Volume 27, Number 1, Page(s) 017-022
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DOI: 10.5146/tjpath.2010.01041 |
Expression of p16 Protein and Cyclin D1 in Periampullary Carcinomas |
Ersin TUNCER2, Nilay ŞEN TÜRK1, Sema ARICI2, Süleyman Ender DÜZCAN1, Neşe ÇALLI DEMİRKAN1 |
1Department of Pathology, Pamukkale University, Faculty of Medicine, DENİZLİ, TURKEY 2Department of Pathology, Cumhuriyet University, Faculty of Medicine, SİVAS, TURKEY |
Keywords:
Carcinoma, p16, Cyclin D1, Ampulla of Vater, Histopathology, Pancreatic ductal carcinoma |
Objective: The majority of the tumors in periampullary region are
pancreatic and ampulla of Vater carcinomas. The aim of this study was
to compare histopathological features of ampulla of Vater carcinomas
with pancreatic ductal adenocarcinomas and to determine diagnostic
and predictive values of p16 protein and cyclin D1 expression.
Material and Method: Tissue samples from pancreatic ductal
adenocarcinomas and ampulla of Vater carcinomas were obtained
from 31 patients who underwent pancreticoduodenectomy for
periampullary carcinoma. The study group was composed of 12
women and 19 men. Their median age was found to be 62.32 years
(range 26-85 years). The parameters analyzed in the study included
lymph node metastases, perineural invasion, differentiation, duodenal
invasion, grade of intraepithelial neoplasia and p16 and cyclinD1
expression in tumoral and peritumoral pancreatic tissues.
Results: In both tumor groups, the loss of p16 protein expression
was significantly correlated with perineural invasion (p=0.0001).
Perineural invasion was more frequent in the pancreatic ductal
adenocarcinoma group than the ampulla of Vater carcinoma group
(p=0,01). When desmoplasia and lymphoplasmacytic stromal
infiltration were examined, desmoplastic reaction was significantly
higher in pancreatic ductal adenocarcinomas than ampulla of Vater
carcinomas (p=0.01). No significant difference was observed between
tumor groups for Cyclin D1 (p>0.05).
Conclusion: The results suggest that loss of p16 protein expression
may be a sign for poor prognosis in periampullary cancers that
is correlated mainly with perineural invasion. Desmoplastic
stromal reaction may be a distinctive feature for pancreatic ductal
adenocarcinoma compared with ampulla of Vater carcinoma.
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