Napovedni dejavniki preživetja bolnikov po resekciji periampularnega adenokarcinoma = Survival predictors after resection of periampullar adenocarcinoma
Tomažič, Aleš, medicina ...
Bacground. The outcome of patient undergoing pancreatoduodenectomy depends on various factors, molecular studies have pointed to the important role of oncogenes, tumor suppressor genes, growth ...factors and factors, which influenceapoptosis. The aim of the studywas to define factors predictive of survival in periampullary adenocarcinoma, to find out the prognostic role of expression of cyclin D1, p27Kipl and bax. Methodology. Prospectively, we collected clinicopathological data about patients operated between 1995 and 1998. Expression of cyclin D1, p27Kipl and bax was determined with immunohistochemical methods. Clinicopathological factors and expression ofcyclin D1, p27Kipl and bax were examined with respect to patient survival. Univariate analyses were performed using the Kaplan-Meier method and log-rank test, and multivariate analysis was done with Cox proportional hazards regression. Results. Fifty five patients were included in study. Actuarial 5-year survival was 29%. Diabetes mellitus, blood transfusion, diameter of tumor, histological type of tumor (pancreatic adenocarcinoma), perineural invasion, lymphnode metastasis, overexpression of cyclin D1 and lower expression of bax and p27Kipl significantly decreased survival according to univariate analysis. In the multivariate analysis, histologic type of tumor (p= 0,001), lymphnode metastases (p = 0,03) and overexpression of cyclin D1 (p= 0,02) independently influenced survival. Conclusions. Our present findingsconfirm that expression of cyclin D1 influences the biological growth behaviour of periampullary adenocarcinomas and contribute to prognosis.
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