Proliferating cell nuclear antigen, p53, and c-erbB-2 expression in relation to clinicopathological variables and prognosis in cancer of the ampulla of Vater

Abstract

Background/aims: Various clinicopathological factors have been thought to influence the prognosis of ampullary cancers. Recent advances in molecular biology should provide much useful information on the prognostic factors of ampullary carcinomas.

Methodology: PCNA (proliferating cell nuclear antigen), p53, and c-erbB-2 were immunohistochemically evaluated in 30 resectable ampullary carcinomas. PCNA, p53, and c-erbB-2 expression, 6 clinicopathological variables, and prognosis were studied and correlations among these factors were investigated.

Results: The mean PCNA-positive rate was 39.1%. The percentages of cases positive for p53 and c-erbB-2 were 53% and 23%, respectively. No correlation was seen between PCNA, p53, or c-erbB-2 expression and clinicopathological variables. The optimum cut-off of PCNA indices influencing recurrence was decided as 40% by receiver operator characteristic curves. The cumulative disease-free survival rate of patients from the > or = 40% PCNA positive rate group was significantly poorer than that of the < 40% PCNA positive rate group (P < 0.01). p53 accumulation and c-erbB-2 expression were not correlated with prognosis. Multivariate analysis revealed that the PCNA positive rate and lymph node metastasis independently contributed to survival (P < 0.05).

Conclusions: PCNA expression is a useful prognostic marker; however, p53 and c-erbB-2 overexpression are not useful as biomarkers for ampullary cancers.