J Korean Surg Soc.  2006 Aug;71(2):119-127.

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

• Jo S
• Heo JS
• Choi SH
• Jang KT
• Oh MJ
• Choi DW
• Chung JC
• Lee SG
• Kim YI

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.

Keyword

Ampulla of Vater carcinoma; Curative resection; Distant recurrence; Ki-67 labeling index; Lymph node metastasis

MeSH Terms

Ampulla of Vater*
Humans
Ki-67 Antigen
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Population Characteristics
Recurrence*
Retrospective Studies
Vascular Endothelial Growth Factor A*
Ki-67 Antigen
Vascular Endothelial Growth Factor A