PMID- 18392709
OWN - NLM
STAT- MEDLINE
DCOM- 20081021
LR  - 20081121
IS  - 0944-1166 (Print)
IS  - 0944-1166 (Linking)
VI  - 15
IP  - 2
DP  - 2008
TI  - Does ampullary carcinoma arise from distended glands in the papilla of Vater?
PG  - 161-8
LID - 10.1007/s00534-007-1228-3 [doi]
AB  - BACKGROUND/PURPOSE: Glands near the surface of the papilla of Vater may become 
      distended with mucus and become hyperplastic; that is, become distended. In this 
      study, we tried to clarify carcinogenesis in these distended glands. METHODS: 
      Twenty-nine pancreatoduodenectomized nontumorous duodenal papilla specimens from 
      carcinoma of the pancreas and bile duct and 34 resected ampullary carcinoma 
      specimens were studied histopathologically and immunohistochemically, using 
      cytokeratins and mucin immunohistochemical features/phenotypes. RESULTS: 
      Distended glands were found in 11 of the 29 pancreatoduodenectomized specimens. 
      These glands were immunopositive for cytokeratin (CK) 7 and MUC-5AC Glycoprotein 
      (MUC5AC), but not for CK20, while the intrapapillary portion was CK7-positive and 
      CK20-negative, but mostly negative for MUC5AC. Immunopositivity for CK7, CK20, 
      and MUC5AC was found in 25, 21, and 18 of the 34 specimens of ampullary 
      carcinoma, respectively. In 23 of the 34 specimens, immunoreactivity for MUC5AC 
      and that for CK7 was coincident, that is, when the former was immunopositive, so 
      was the latter, and vice versa, while in 25 of the 34 specimens, immunoreactivity 
      for MUC5AC was opposite to that for CK20. Among the 23 cases in which 
      immunoreactivity for MUC5AC and CK7 was coincident, 10 were MUC5AC+, CK7+, CK20- 
      and 7 were MUC5AC-, CK7-, CK20+, suggestive of disease arising from the 
      pancreaticobiliary mucosa or the distended glands in the former and disease 
      arising from the duodenal mucosa in the latter. In MUC5AC+ cases, other than the 
      10 cases of MUC5AC+, CK7+, CK20-, 6 were double-positive and 1 was 
      double-negative for CK7 and CK20, and 1 was CK20-positive, and at least 1 case 
      showing double-negativity for CK7 and CK20 was suggestive of disease arising from 
      the distended glands. CONCLUSIONS: Although most ampullary carcinomas arise from 
      the duodenal mucosa or intra-ampullary mucosa, both CK7-positive and 
      MUC5AC-positive or only MUC5ACpositive ampullary carcinomas may arise from the 
      distended glands.
FAU - Sonoue, Hiroshi
AU  - Sonoue H
AD  - Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 
      Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
FAU - Suda, Koichi
AU  - Suda K
FAU - Nobukawa, Bunsei
AU  - Nobukawa B
FAU - Abe, Hiroshi
AU  - Abe H
FAU - Arakawa, Atsushi
AU  - Arakawa A
FAU - Hirai, Shu
AU  - Hirai S
FAU - Matsumoto, Toshiharu
AU  - Matsumoto T
LA  - eng
PT  - Journal Article
DEP - 20080406
PL  - Japan
TA  - J Hepatobiliary Pancreat Surg
JT  - Journal of hepato-biliary-pancreatic surgery
JID - 9431940
RN  - 0 (Keratin-7)
RN  - 0 (MUC5AC protein, human)
RN  - 0 (Mucin 5AC)
RN  - 0 (Mucins)
SB  - IM
MH  - Aged
MH  - Ampulla of Vater/*pathology
MH  - Common Bile Duct Neoplasms/*metabolism/*pathology/surgery
MH  - Humans
MH  - Hyperplasia
MH  - Immunohistochemistry
MH  - Keratin-7/biosynthesis
MH  - Middle Aged
MH  - Mucin 5AC
MH  - Mucins/biosynthesis
MH  - Pancreaticoduodenectomy
EDAT- 2008/04/09 09:00
MHDA- 2008/10/22 09:00
CRDT- 2008/04/09 09:00
PHST- 2007/01/29 00:00 [received]
PHST- 2007/03/17 00:00 [accepted]
PHST- 2008/04/09 09:00 [pubmed]
PHST- 2008/10/22 09:00 [medline]
PHST- 2008/04/09 09:00 [entrez]
AID - 10.1007/s00534-007-1228-3 [doi]
PST - ppublish
SO  - J Hepatobiliary Pancreat Surg. 2008;15(2):161-8. doi: 10.1007/s00534-007-1228-3. 
      Epub 2008 Apr 6.