Prognostic Analysis Of Duodenal Papillary Adenocarcinoma And Expression And Significance Of Tiam1, C-met And Cdx-2 In Tissues

Part ? Prognostic analysis of clinical pathological characteristics of duodenal papilla adenocarcinoma treated by pancreatoduodenectomy: A 194 cases reportObjective:To investigate the relationship between the pathological characteristics and prognosis of duodenal papillary adenocarcinoma.Methods:The clinical and pathological data of 194 patients undergoing pancreatoduodenectomy and afterwards pathological diagnosed to duodenal papillary adenocarcinoma from January 2011 to December2016 at the Department of Hepatobiliary Surgery of Hunan Provincial People's Hospital was retrospectively analyzed.The postoperative survival condition of the patients was followed-up and factors affecting patient survival was analyzed.Results:Postoperative pathological diagnosis has shown 6 cases with well-differentiated adenocarcinoma(3.1%),112 cases with moderatelydifferentiated adenocarcinoma(57.7%),and 76 cases with poorly-differentiated adenocarcinoma(39.2%).With the decrease ofdifferentiation,a significant increase on lymph node metastasis rate(P=0.000)and no significant difference on nerve infiltration rate(P=0.585)were observed.Median survival of the entire cohort was 37 months.Overall actuarial survival at 1,3,and 5 years was 81.6%?50.1%?36.9%,respectively.Univariate analysis suggested that preoperative serum carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),T stage,differentiation,lymph node metastasis,and nerve infiltration remarkably influenced the postoperative survival.On multivariate analysis,positive lymph node state was an independent risk factor for postoperative survival(RR=1.953,95%CI 1.043-3.654,P=0.036).Conclusion:Univariate analysis suggested that preoperative serum carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),T stage,differentiation,lymph node metastasis,and nerve infiltration remarkably influenced the postoperative survival.The lymph node metastasis is independent risk factor for postoperative survival.Part ? Expression and Clinical Prognosis of Tiam1,C-met and Cdx-2 in Duodenal Papillary AdenocarcinomaObjective:The expression of Tiam1,c-met and cdx-2 in the tissues of duodenal papillary adenocarcinoma were detected to grasp the relationship between the clinicopathological characteristics and prognosis of Tiam1,c-met and cdx-2 in duodenal papillary adenocarcinoma,so as to prepare for whether the expressions of Tiam1,c-met and cdx-2 can be used as prognostic indicators and guide targeted therapy in duodenal papillary adenocarcinoma patients.Methods:Using the random number table method,30 cases of archived wax blocks without radiotherapy and chemotherapy were selected from 194 cases of duodenal papillary adenocarcinoma as the experimental group,the normal tissues adjacent to tumor as the control group.Immunohistochemistry was performed to evaluate the expression of Tiam1,c-met and cdx-2 in two tissue sections.Spearman correlation analysis was used to analyze their correlation.The experimental group was divided into different groups according to gender and age,TNM stage differentiation,lymph node metastasis and nerve infiltration,and the expressions of Tiam1,c-met and cdx-2 in different groups were compared.Survivalcurves were made according to the follow-up results of patients and the positive expression of Tiam1,c-met and cdx-2,and the relationship between the expression of Tiam1,c-met and cdx-2,and the prognosis of duodenal papillary adenocarcinoma was evaluated.Finally,image collection and statistical analysis were performed for the experimental results.Results:We demonstrated that Tiam1,c-met and cdx-2 is overexpressed in he duodenal papillary adenocarcinoma tissues compared with adjacent normal mucosa(P<0.05).2.The correlation coefficient of IOD value of Tiam1 and c-met was 0.791,that of cdx-2 and Tiam1 was 0.745,and that of c-met and cdx-2 was 0.589,which were positively correlated with each other.Tiam1,c-met and cdx-2 was low expressed in the tissues of tumor without lymphatic metastasis and stage ?+? stage in high school differentiation.Tiam1,c-met and cdx-2 was highly expressed in poorly differentiated tissues with lymph node metastasis and stage ?+? duodenal papillary adenocarcinoma(P < 0.05).The expression of Tiam1,c-met and cdx-2 was independent of age,gender,and presence of nerve infiltration in tumor(P > 0.05).The median survival time of patients with positive cdx-2 expression(66 months)was significantly higher than that of patients with negative expression(24 months,P<0.05),while the positive expression of Tiam1 and C-met had no statistical significance for the prognosis of patients.Conclusion:Abnormal expression of Tiam1,c-met and cdx-2 was associated with the clinicopathological characteristics of duodenal papillary adenocarcinoma.But,patients with positive expression of cdx-2 had poorer prognosis than those with negative expression.