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( Rohyun Sung ),( Li Kang ),( Joung Ho Han ),( Jae Woon Choi ),( Sang Hwa Lee ),( Tae Hoon Lee ),( Sang Heum Park ),( Hong Ja Kim ),( Eaum Seok Lee ),( Young Suk Kim ),( Young Woo Choi ),( Seon Mee Pa The Editorial Office of Gut and Liver 2014 Gut and Liver Vol.8 No.1
Background/Aims: Epithelial-mesenchymal transition (EMT)-related proteins may exhibit differential expression in intestinal type or pancreatobiliary type ampulla of Vater carcinomas (AVCs). We evaluated the expression of E-cadherin, b-catenin, and S100A4 in intestinal and nonintestinal type AVCs and analyzed their relationships with clinicopathological variables and survival. Methods: A clinicopathological review of 105 patients with AVCs and immunohistochemical staining for E-cadherin, b-catenin, and S100A4 were performed. The association between clinicopathological parameters, histological type, and expression of EMT proteins and their effects on survival were analyzed. Results: Sixty-five intestinal type, 35 pancreatobiliary type, and five other types of AVCs were identified. The severity of EMT changes differed between the AVC types, membranous loss of E-cadherin and b-catenin was observed in nonintestinal type tumors, whereas aberrant nonmembranous b-catenin expression was observed in intestinal type tumors. EMT-related changes were more pronounced in the invasive tumor margin than in the tumor center, and these EMT-related changes were related to tumor aggressiveness. Among the clinicopathological parameters, a desmoplastic reaction was related to overall survival, and the reaction was more severe in nonintestinal type than in intestinal type AVCs. Conclusions: Dysregulation of E-cadherin, β-cadherin, and S100A4 expression may play a role in the carcinogenesis and tumor progression of AVCs. (Gut Liver 2014,8:94-101)