Periampullary cancers (PAC) including pancreatic, ampulla of Vater (AOV), and common bile duct (CBD) cancers are highly aggressive with a lack of useful prognostic markers beyond T stage. However, T staging can be biased due to the anatomic complexity of this region. Recently, several markers related to cancer stem cells and epithelial-mesenchymal transition (EMT) such as octamer transcription factor-4 (Oct4) and fibroblast growth factor receptor 1 (FGFR1) respectively, have been proposed as new promising markers in other solid cancers. The aim of this study was to assess the expression and prognostic significance of stem cell/EMT markers in PACs. Formalin-fixed, paraffin-embedded tissues of surgically excised PACs from the laboratory archives from 1998 to 2014 were evaluated by immunohistochemical staining for stem cell/EMT markers using tissue microarray. The clinicopathologic parameters were documented and statistically analyzed with the immunohistochemical findings. Survival and recurrence data were collected and analyzed. A total of 126 PAC cases were evaluated. The average age was 63 years, with 76 male and 50 female patient samples. Age less than 74 years, AOV cancers, lower T & N stage, lower tumor size, no lymphatic, vascular, perineural invasion and histologic well differentiation, intestinal type, no fibrosis, severe inflammation were significantly associated with the better overall survival High expression levels of FGFR1 as well as CK20, CDX2, and VEGF were significantly related to better overall survival, while other stem cell markers were not related. Similar findings were observed for tumor recurrence using disease-free survival. In addition to other clinicopathologic parameters, severe fibrosis was related to frequent tumor recurrence, and high FGFR1 expression was associated with better overall survival. Histologic changes such as extensive fibrosis need to be investigated further in relation to EMT of PACs.

中文翻译：

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干细胞/上皮间质转化标志物在壶腹周围癌/胰腺癌中的预后意义：FGFR1是一种有前途的预后标志物


壶腹周围癌 (PAC) 包括胰腺癌、法特壶腹 (AOV) 癌和胆总管 (CBD) 癌，具有高度侵袭性，且缺乏 T 期以外的有用预后标志物。然而，由于该区域的解剖复杂性，T 分期可能会有偏差。最近，与癌症干细胞和上皮间质转化（EMT）相关的几种标记物，例如八聚体转录因子4（Oct4）和成纤维细胞生长因子受体1（FGFR1），已被提议作为其他实体癌的新的有前途的标记物。本研究的目的是评估 PAC 中干细胞/EMT 标志物的表达和预后意义。使用组织微阵列对 1998 年至 2014 年实验室档案中手术切除的 PAC 进行福尔马林固定、石蜡包埋的组织，通过干细胞/EMT 标记物的免疫组织化学染色进行评估。记录临床病理参数并用免疫组织化学结果进行统计分析。收集并分析生存和复发数据。总共评估了 126 个 PAC 案例。平均年龄为 63 岁，其中男性 76 名，女性 50 名。年龄小于74岁、AOV癌症、较低T&N分期、较小肿瘤大小、无淋巴管、血管、神经周围浸润和组织学分化良好、肠型、无纤维化、严重炎症与较好的总生存率显着相关 高表达水平FGFR1 以及 CK20、CDX2 和 VEGF 与更好的总体生存率显着相关，而其他干细胞标志物则不相关。使用无病生存率观察肿瘤复发的类似结果。 除了其他临床病理参数外，严重纤维化与肿瘤频繁复发有关，FGFR1 高表达与更好的总生存期相关。需要进一步研究与 PAC 的 EMT 相关的组织学变化（例如广泛纤维化）。