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Volume 30
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Review

Ampullary Cancer: Histological Subtypes, Markers, and Clinical Behaviour—State of the Art and Perspectives

by
Gennaro Nappo
1,2,*,†,
Niccola Funel
3,†,
Virginia Laurenti
1,
Elisabetta Stenner
3,
Silvia Carrara
4,
Silvia Bozzarelli
5,
Paola Spaggiari
6 and
Alessandro Zerbi
1,2
1
Pancreatic Surgery Unit, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Italy
2
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
3
USL Toscana Nordovest, Chemical-Clinical Analysis Laboratory, Department of Diagnostics, 56121 Pisa, Italy
4
Endoscopic Unit, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Italy
5
Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Italy
6
Pathology Unit, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Curr. Oncol. 2023, 30(7), 6996-7006; https://doi.org/10.3390/curroncol30070507
Submission received: 29 June 2023 / Revised: 15 July 2023 / Accepted: 20 July 2023 / Published: 22 July 2023
(This article belongs to the Special Issue Combination Therapy in Gastrointestinal Cancers)
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Abstract

There are different cancers in the peri-ampullary region, including pancreatic ductal adenocarcinoma (PDAC), duodenum cancers (DCs), and ampullary adenocarcinoma (AAC). Here, significant morphological–molecular characterizations should be necessary for the distinction of primary tumours and classifications of their subtypes of cancers. The sub classification of AACs might include up to five different variants, according to different points of view, concerning the prevalence of the two more-cellular components found in the ampulla. In particular, regarding the AACs, the most important subtypes are represented by the intestinal (INT) and the pancreato-biliary (PB) ones. The subtyping of AACs is essential for diagnosis, and their identifications have been impacting clinical management responses to treatments and overall survival (os) after surgery. Pb is associated with a worse clinical outcome. Otherwise, the criteria, through which are possible to attribute its subtype classification, are not well established. A triage of immune markers represented by CK7, CK20, and CDX-2 seem to represent the best compromise in order to split the cohort of AAC patients in the INT and PB groups. The test of choice for the sub-classification of AACs is represented by the immuno-histochemical approach, in which its molecular classification acquires its diagnostic, predictive, and prognostic value for both the INT and PB patients.
Keywords: ampullary adenocarcinomas (AAC); subtypes; molecular markers; immuno-histochemistry; clinical behaviours; clinical management; CK7; CK20; CDX2 ampullary adenocarcinomas (AAC); subtypes; molecular markers; immuno-histochemistry; clinical behaviours; clinical management; CK7; CK20; CDX2

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MDPI and ACS Style

Nappo, G.; Funel, N.; Laurenti, V.; Stenner, E.; Carrara, S.; Bozzarelli, S.; Spaggiari, P.; Zerbi, A. Ampullary Cancer: Histological Subtypes, Markers, and Clinical Behaviour—State of the Art and Perspectives. Curr. Oncol. 2023, 30, 6996-7006. https://doi.org/10.3390/curroncol30070507

AMA Style

Nappo G, Funel N, Laurenti V, Stenner E, Carrara S, Bozzarelli S, Spaggiari P, Zerbi A. Ampullary Cancer: Histological Subtypes, Markers, and Clinical Behaviour—State of the Art and Perspectives. Current Oncology. 2023; 30(7):6996-7006. https://doi.org/10.3390/curroncol30070507

Chicago/Turabian Style

Nappo, Gennaro, Niccola Funel, Virginia Laurenti, Elisabetta Stenner, Silvia Carrara, Silvia Bozzarelli, Paola Spaggiari, and Alessandro Zerbi. 2023. "Ampullary Cancer: Histological Subtypes, Markers, and Clinical Behaviour—State of the Art and Perspectives" Current Oncology 30, no. 7: 6996-7006. https://doi.org/10.3390/curroncol30070507

APA Style

Nappo, G., Funel, N., Laurenti, V., Stenner, E., Carrara, S., Bozzarelli, S., Spaggiari, P., & Zerbi, A. (2023). Ampullary Cancer: Histological Subtypes, Markers, and Clinical Behaviour—State of the Art and Perspectives. Current Oncology, 30(7), 6996-7006. https://doi.org/10.3390/curroncol30070507

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