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

Background/Aims: Various clinicopathological factors have been thought to i nfluence the prognosis of ampullary cancers. Recent advances in molecular b iology should provide much useful information on the prognostic factors of ampullary carcinomas. Methodology: PCNA (proliferating cell nuclear antigen), p53, and c-erbB-2 w ere immunohistochemically evaluated in 30 resectable ampullary carcinomas. PCNA, p53, and c-erbB-2 expression, 6 clinicopathological variables, and pr ognosis were studied and correlations among these factors were investigated . Results: The mean PCNA-positive rate was 39.1%. The percentages of cases po sitive 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 cutoff of PCNA indices influencing recurrence was de cided as 40% by receiver operator characteristic curves. The cumulative dis ease-free survival rate of patients from the 40% PCNA positive rate group w as 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 p rognosis. Multivariate analysis revealed that the PCNA positive rate and ly mph node metastasis independently contributed to survival (P < 0.05). Conclusions: PCNA expression is a useful prognostic marker; however, p53 an d c-erbB-2 overexpression are not useful as biomarkers for ampullary cancer s.