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Abstract
The magnetite nanoparticles are progressively used in a wide range of biological applications. In the present study, we purposed to show apoptosis-inducing ability of Fe3O4 nanopowders on A549 cells. In addition, the toxic effects of Fe3O4 nanopowders were researched on L929 cells. The cytotoxicity of Fe3O4 nanopowders were evaluated on A549 and L929 cells by MTT assay and inhibited cell proliferation by time and dose-dependent manner on A549 cells but was not toxic on L929 cells. According to these findings, IC30 value of Fe3O4 nanopowders was determined as 5 µM. The early and late apoptotic cells were detected by Annexin V-FITC/PI assay using IC30 concentration of Fe3O4 nanopowders. Furthermore, The IC30 value of Fe3O4 nanopowders was not effective in the activation of caspase-3 but was effective on loss of mitochondrial membrane potential. The apoptotic index of A549 cells was investigated and found out to increase by IC30 value of Fe3O4 nanopowders using TUNEL, BrdU, Bcl-2 immunocytochemical assays. The upregulated and downregulated genes were profiled and the presence of some apoptotic genes was determined with administration of IC30 value of Fe3O4 nanopowders by microarray assay. This work suggests that Fe3O4 nanopowders could be a good candidate for therapy of lung adenocarcinoma cells.
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Affiliation(s)
- Ayse Kaplan
- Department of Biology, Faculty of Science, Eskisehir Technical University, Eskisehir, Turkey
| | - Hatice Mehtap Kutlu
- Department of Biology, Faculty of Science, Eskisehir Technical University, Eskisehir, Turkey
| | - Gulsen Akalin Ciftci
- Faculty of Pharmacy, Department of Biochemistry, Anadolu University, Eskisehir, Turkey
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Negara KS, Prajawati NLLC, Surya GP, Suhendro S, Arijana K, Tunas K. Protein 53 (P53) Expressions and Apoptotic Index of Amniotic Membrane Cells in the Premature Rupture of Membranes. Open Access Maced J Med Sci 2018; 6:1986-1992. [PMID: 30559848 PMCID: PMC6290400 DOI: 10.3889/oamjms.2018.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND: The premature rupture of membranes (PROM) represents an obstetric issue causing significant maternal and neonatal morbidity and mortality. Although protein 53 (p53), one of the proapoptotic proteins suspected of causing PROM at the molecular level is closely correlated with the occurrence of PROM, the exact mechanism remains still unclear. AIM: This study aims to investigate the hypothesis that p53 expression and the apoptotic index play a role in the PROM mechanism. METHODS: Placentas from 20 pregnancies (37–42 weeks gestation) and 20 pregnancies complicated by PROM were collected at delivery. The independent variable is represented by pregnant mothers with a single live fetus experiencing PROM (followed by labour and birth) while without PROM mothers represent the control. The research material was taken from the amnion tissue in the placenta. Also, p53 and apoptotic index (TUNEL) immunohistochemical examination were conducted at the Integrated Biomedical Laboratory, Medical Faculty of Udayana University, Bali. The correlation between the apoptotic index and p53 expression of the PROM group was tested using a McNemar Test. RESULTS: No statistically significant differences were found between the two groups (p > 0.05). There was a significant difference in p53 expression in PROM cases compared to those without PROM (11.15 + 5.59% vs. 0.95 + 2.52%) with χ2 = 19.538 and p = 0.001. The apoptotic index in PROM cases was higher than in those without PROM (19.10 + 5.63% vs. 1.15 + 2.46%) with χ2 = 32.40 and p = 0.001. There was a strong correlation between p53 expression and PROM with PR = 3.449 (95% CI = 1.801-6.605; p = 0.001). There was a strong correlation between the apoptotic index and PROM with PR = 19 (95% CI = 2.81-128.69; p = 0.001). CONCLUSION: p53 expression and the apoptotic index of amniotic membrane cells in cases of PROM was higher than in those without PROM, there was a strong correlation between p53 expression and apoptotic index with the occurrence of PROM.
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Affiliation(s)
- Ketut Surya Negara
- Department of Obstetrics and Gynecology, Udayana University, Sanglah Hospital, Bali, Indonesia
| | | | - Gede Putu Surya
- Department of Obstetrics and Gynecology, Udayana University, Sanglah Hospital, Bali, Indonesia
| | | | - Komang Arijana
- Integrated Biomedical Laboratory, Medical Faculty of Udayana University, Bali, Indonesia
| | - Ketut Tunas
- Department of Public Health, Dhyana Pura University, Bali, Indonesia
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Zhang W, Duan R, Zhang J, Cheung WKC, Gao X, Zhang R, Zhang Q, Wei M, Wang G, Zhang Q, Mei PJ, Chen HL, Kung H, Lin MC, Shen Z, Zheng J, Zhang L, Yao H. H1/pHGFK1 nanoparticles exert anti-tumoural and radiosensitising effects by inhibition of MET in glioblastoma. Br J Cancer 2018; 118:522-33. [PMID: 29348487 DOI: 10.1038/bjc.2017.461] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 11/23/2017] [Accepted: 11/23/2017] [Indexed: 12/20/2022] Open
Abstract
Background: The therapeutic resistance to ionising radiation (IR) and anti-angiogenesis mainly impair the prognosis of patients with glioblastoma. The primary and secondary MET aberrant activation is one crucial factor for these resistances. The kringle 1 domain of hepatocyte growth factor (HGFK1), an angiogenic inhibitor, contains a high-affinity binding domain of MET; however, its effects on glioblastoma remain elusive. Methods: We formed the nanoparticles consisting of a folate receptor-targeted nanoparticle-mediated HGFK1 gene (H1/pHGFK1) and studied its anti-tumoural and radiosensitive activities in both subcutaneous and orthotopic human glioma cell-xenografted mouse models. We then elucidated its molecular mechanisms in human glioblastoma cell lines in vitro. Results: We demonstrated for the first time that peritumoural injection of H1/pHGFK1 nanoparticles significantly inhibited tumour growth and prolonged survival in tumour-bearing mice, as well as enhanced the anti-tumoural efficacies of IR in vivo by reducing Ki-67 expression, enhancing TUNEL staining-indicated apoptotic indexes, reducing microvascular intensity and reversing IR-induced MET overexpression in tumour tissues. Furthermore, we showed that HGFK1 suppressed the proliferation and induced cell apoptosis and enhanced sensitivity to IR in glioblastoma cell lines, mainly by suppressing the activities of MET receptor, down-regulating ATM-Chk2 axis but up-regulating Chk1. Conclusions: H1/pHGFK1 exerts anti-tumoural and radiosensitive activities mainly through the inhibition and reversal of IR-induced MET and ATM–Chk2 axis activities in glioblastoma. H1/pHGFK1 nanoparticles are a potential radiosensitiser and angiogenic inhibitor for glioblastoma treatment.
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Perysinakis I, Minaidou E, Mantas D, Sotiropoulos GC, Leontara V, Tsipras H, Zografos GN, Margaris I, Kouraklis G. Differentiation and prognostic markers in ampullary cancer: Role of p53, MDM2, CDX2, mucins and cytokeratins. Pathol Res Pract 2016; 212:1039-47. [DOI: 10.1016/j.prp.2016.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 09/01/2016] [Accepted: 09/09/2016] [Indexed: 12/23/2022]
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Perysinakis I, Minaidou E, Leontara V, Mantas D, Sotiropoulos GC, Tsipras H, Zografos GN, Margaris I, Kouraklis G. Differential Expression of β-Catenin, EGFR, CK7, CK20, MUC1, MUC2, and CDX2 in Intestinal and Pancreatobiliary-Type Ampullary Carcinomas. Int J Surg Pathol 2016; 25:31-40. [DOI: 10.1177/1066896916664987] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: The purpose of this study was to associate immunohistochemical expression of β-catenin, EGFR, CK7, CK20, MUC1, MUC2, and CDX2 in ampullary adenocarcinomas with the type of differentiation and prognosis. Methods: Forty-seven patients with ampullary adenocarcinoma who underwent pancreatoduodenectomy with curative intent from 1997 to 2014 were included in this study. Nine patients with perioperative death were included in the association analysis but excluded from survival analysis. All tumors were classified as intestinal or pancreatobiliary type, according to histologic criteria, and immunohistochemically stained against the aforementioned markers. Results: Eighteen carcinomas were classified as intestinal type and 29 carcinomas as pancreatobiliary type. Univariate analysis revealed that CK20 and CDX2 expression correlates with intestinal type, whereas MUC1 positivity indicates pancreatobiliary type. A marginally significant trend was shown for intestinal-type tumors toward larger size and more frequent MUC2 expression. Using multivariate analysis CK20 ( P = .003) and MUC1 ( P = .004) were identified as independent predictors of the intestinal and pancreatobiliary types, respectively. Mean and median survival was 90.3 and 55 months, respectively. Overall 5-year survival rate was 48%. On univariate survival analysis, overall survival was adversely influenced by the number of infiltrated lymph nodes, elevated Ca19-9 serum levels, jaundice, poor differentiation, T4 stage, N1 stage, TNM stage III, and CDX2 immunonegativity. Multivariate analysis identified TNM stage as the only independent prognostic factor in ampullary adenocarcinoma ( P = .048). Conclusions: Immunoreactivity against CK20 and MUC1 in ampullary carcinomas is a useful adjunct to histologic examination in determining histotype. None of the immunohistochemical markers studied had prognostic significance.
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Affiliation(s)
- Iraklis Perysinakis
- Third Surgical Department, “George Gennimatas” General Hospital, Athens, Greece
| | - Emilia Minaidou
- Pathology Department, “George Gennimatas” General Hospital, Athens, Greece
| | - Vasileia Leontara
- Pathology Department, “George Gennimatas” General Hospital, Athens, Greece
| | - Dimitrios Mantas
- Second Department of Propaedeutic Surgery, Laiko Hospital, Athens University Medical School, Greece
| | - Georgios C. Sotiropoulos
- Second Department of Propaedeutic Surgery, Laiko Hospital, Athens University Medical School, Greece
| | - Hercules Tsipras
- Third Surgical Department, “George Gennimatas” General Hospital, Athens, Greece
| | - George N. Zografos
- Third Surgical Department, “George Gennimatas” General Hospital, Athens, Greece
| | - Ilias Margaris
- Third Surgical Department, “George Gennimatas” General Hospital, Athens, Greece
| | - Gregory Kouraklis
- Second Department of Propaedeutic Surgery, Laiko Hospital, Athens University Medical School, Greece
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Tekin N, Ustuner MC, Akyuz F, Ozbayer CS, Aydın O, Benkli K, Burukoglu D, Degirmenci I, Ozden H. Apoptotic effects of dipyrido [3,2-a:2',3'-c] phenazine (dppz) Au(III) complex against diethylnitrosamine/phenobarbital induced experimental hepatocarcinogenesis in rats. Mol Biol Rep 2014; 41:5109-21. [PMID: 24756331 DOI: 10.1007/s11033-014-3376-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 04/11/2014] [Indexed: 01/26/2023]
Abstract
We evaluated the effects of dipyrido [3,2-a:2',3'-c] phenazine (dppz) Au(III) complex ([Au(dppz)Cl2]Cl) on apoptosis during chemically induced hepatocellular carcinoma. 48 male Spraque-Dawley rats were divided into six groups; group I (control), group II [Dimethyl sulfoxide (DMSO)], group III ([Au(dppz)Cl2]Cl), group IV [diethylnitrosamine + Phenobabital (DEN + PB)], group V (DEN + PB + [Au(dppz)Cl2]Cl (2nd week)), and group VI (DEN + PB + [Au(dppz)Cl2]Cl (7th week). The rats in groups IV through VI were administrated with DEN in a single dose of intraperitoneal 175 mg/kg. After 2 weeks of DEN administration, these groups of rats were given daily PB in a dose of 500 ppm. In group V, after two weeks of DEN administration, [Au(dppz)Cl2]Cl complex (2 mg/kg) was given once a week by intraperitoneal injection. In the group VI, the rats were given a dose of 2 mg/kg [Au(dppz)Cl2]Cl complex once a week, 7 weeks after DEN administration. At the end of the study, blood and tissue samples were collected from the rats to determine levels of serum AST, ALT, and LDH, and caspase 3, p53, Bax, Bcl-2 and DNA fragmentation in liver. AST, ALT, LDH, and Bcl-2 levels were higher in group IV, compared to group I, but caspase 3 and p53 levels were lower. In group V, caspase 3, p53, Bax, and DNA fragmentation levels were higher than those of group IV. Caspase 3 and p53 levels increased in group VI compared with group IV. In conclusion, [Au(dppz)Cl2]Cl complex induced apoptosis by elevating levels of caspase 3, p53, Bax, and DNA fragmentation.
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Abstract
AIMS Ampullary cancer is a relatively uncommon tumour, with a better prognosis than pancreatic cancer. The purpose of this study was to review the recent literature on ampullary adenocarcinoma, focusing on histological types and prognostic factors. METHODS AND RESULTS Using PubMed, we carried out a comprehensive search of the literature, which was extended to April 2013 to retrieve all additional publications. Ampullary cancer comprises two main histological subtypes, the pancreatobiliary type and the intestinal type. These subtypes have different pathogenetic and clinical characteristics. Clinical and histological parameters as well as immunohistochemical markers have been identified as significant prognostic factors in ampullary cancer. Moreover, several immunohistochemical markers have been studied, not only as prognostic factors but as a means of differentiating ampullary from other peri-ampullary tumours, and of identifying the exact histological subtype. CONCLUSIONS The considerable differences in the frequencies of the two subtypes of ampullary tumours reported in literature reinforce the necessity to define molecular markers to distinguish them. Until then, the significance of the histological subtype as a prognostic factor should be evaluated cautiously. Future research on the pathogenesis of ampullary cancer will possibly suggest that we should stop treating this type of cancer as a separate entity.
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Affiliation(s)
- Iraklis Perysinakis
- Third Department of Surgery, 'George Gennimatas' General Hospital, Athens, Greece
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Choi W, An S, Kwon E, Eo W, Lee S. Impact of Standardized Allergen-Removed Rhus verniciflua Stokes Extract on Advanced Adenocarcinoma of the Ampulla of Vater: A Case Series. Evid Based Complement Alternat Med 2013; 2013:203168. [PMID: 23710214 DOI: 10.1155/2013/203168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 04/03/2013] [Indexed: 12/29/2022]
Abstract
Background. Adenocarcinoma of the ampulla of Vater (AAV) is a rare malignancy that has a better prognosis than other periampullary cancers. However, the standard treatment for patients with relapsed or metastatic AAV has not been established. We investigated the clinical feasibility of standardized allergen-removed Rhus verniciflua stokes (aRVS) extract for advanced or metastatic AAV. Patients and Methods. From July 2006 to April 2011, we retrospectively reviewed all patients with advanced AAV treated with aRVS extract alone. After applying inclusion/exclusion criteria, 12 patients were eligible for the final analysis. We assessed the progression-free survival (PFS) and overall survival (OS) of these patients during the follow-up period. Results. The median aRVS administration period was 147.0 days (range: 72–601 days). The best tumor responses according to Response Evaluation Criteria in Solid Tumors were as follows: two with complete response, two with stable disease, and eight with progressive disease. The median OS was 15.1 months (range: 4.9–25.1 months), and the median PFS was 3.0 months (range: 1.6–11.4 months). Adverse reactions to the aRVS treatment were mostly mild and self-limiting. Conclusions. Prolonged survival was observed in patients with advanced AAV under the treatment of standardized aRVS extract without significant adverse effects.
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Sakabe R, Murakami Y, Uemura K, Sudo T, Hashimoto Y, Kondo N, Nakashima A, Ohge H, Sueda T, Hiyama E. Prognostic Significance of Telomerase Activity and Human Telomerase Reverse Transcriptase Expression in Ampullary Carcinoma. Ann Surg Oncol 2012; 19:3072-80. [DOI: 10.1245/s10434-012-2245-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Indexed: 12/19/2022]
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Wang J, Wang X, Xie S, Yan Z, Li Z, Li Y, Wang L, Jiao F. p53 status and its prognostic role in extrahepatic bile duct cancer: a meta-analysis of published studies. Dig Dis Sci 2011; 56:655-62. [PMID: 20668938 DOI: 10.1007/s10620-010-1352-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 07/12/2010] [Indexed: 02/01/2023]
Abstract
The dysfunction of p53 is the most common genetic alteration in human cancer. A variety of studies have investigated the clinicopathologic correlation of p53 and its impact on patient survival in different types of cancer. For extrahepatic bile duct cancer (EBDC), however, the results were limited and conflicting. In this study, we performed an investigation to confirm whether there was a correlation between p53 status and some routine parameters. To further observe the impact of p53 on the survival of EBDC patients, a meta-analysis based on published studies was conducted. Candidate studies were searched from PubMed, EMBASE, and ISI Web of Science. Our results demonstrated that there were significant correlations between p53 expression and some clinicopathological parameters. Furthermore, the pooled results of the meta-analysis showed that the combined hazard ratio (HR) estimate for overall survival (OS) was 1.53 (95% CI, 1.10-2.14) and 1.23 (95% CI, 0.93-1.75) in univariate and multivariate analysis, respectively. In conclusion, the high level of p53 appears to be an effective prognostic factor to OS of EBDC patients. However, some limitations unavoidable in this meta-analysis and problems of previous p53 studies in EBDC mean that further studies are necessary before significant conclusions can be made.
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Affiliation(s)
- Juan Wang
- Department of Biotechnology, Binzhou Medical College, 264003, Yantai, Shandong Province, People's Republic of China
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Vincenzi B, Santini D, Perrone G, Russo A, Adamo V, Rizzo S, Castri F, Antinori A, Alloni R, Crucitti P, Morini S, Rabitti C, Vecchio F, Magistrelli P, Coppola R, Tonini G. Promyelocytic leukemia (PML) gene expression is a prognostic factor in ampullary cancer patients. Ann Oncol 2009; 20:78-83. [DOI: 10.1093/annonc/mdn558] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Santini D, Perrone G, Vincenzi B, Lai R, Cass C, Alloni R, Rabitti C, Antinori A, Vecchio F, Morini S, Magistrelli P, Coppola R, Mackey JR, Tonini G. Human equilibrative nucleoside transporter 1 (hENT1) protein is associated with short survival in resected ampullary cancer. Ann Oncol 2008; 19:724-8. [PMID: 18187485 DOI: 10.1093/annonc/mdm576] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Gemcitabine is an acceptable alternative to best supportive care in the treatment of advanced biliary tract cancers. The human equilibrative nucleoside transporter 1 (hENT1) is a ubiquitous protein and is the major means by which gemcitabine enters human cells. Moreover, recent reports indicate a significant correlation between immunohistochemical variations of hENT1 in tumor samples and survival after gemcitabine therapy in patients with solid tumors. MATERIALS AND METHODS We used immunohistochemistry to assess the abundance and distribution of hENT1 in tumor samples from radically resected cancer of the ampulla, and sought correlations between immunohistochemical results and clinical parameters including disease outcomes. RESULTS In the 41 individual tumors studied, 12 (29.3%) had uniformly high hENT1 immunostaining. Statistical analysis showed a significant correlation between hENT1 and Ki-67 (P = 0.04). No statistical significant differences were found between immunohistochemical findings and patient characteristics (sex, age, and tumor-node-metastasis). On univariate analysis, hENT1 and Ki-67 expression were associated with overall survival (OS). Specifically, those patients with overexpression of hENT1 showed a shorter OS (P = 0.022) and those with high Ki-67 staining showed a shorter survival (P = 0.05). CONCLUSIONS hENT1 expression is a molecular prognostic marker for patients with resected ampullary cancer and holds promise as a predictive factor to assist in chemotherapy decisions.
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Affiliation(s)
- D Santini
- Department of Medical Oncology, University Campus Bio-Medico, via Emilio Longoni 81, 00155 Rome, Italy.
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Kaseta MKA, Khaldi L, Gomatos IP, Tzagarakis GP, Alevizos L, Leandros E, Papagelopoulos PJ, Soucacos PN. Prognostic value of bax, bcl-2, and p53 staining in primary osteosarcoma. J Surg Oncol 2008; 97:259-66. [DOI: 10.1002/jso.20913] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Santini D, Vincenzi B, Tonini G, Scarpa S, Vasaturo F, Malacrino C, Vecchio F, Borzomati D, Valeri S, Coppola R, Magistrelli P, Nuzzo G, Picciocchi A. Cyclooxygenase-2 overexpression is associated with a poor outcome in resected ampullary cancer patients. Clin Cancer Res 2005; 11:3784-9. [PMID: 15897577 DOI: 10.1158/1078-0432.ccr-04-2136] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To identify potential prognostic molecular factors in ampullary adenocarcinoma that could be of significant importance. To this end, we examined the possible prognostic significance of cyclooxygenase-2 (Cox-2) and Survivin expression and the apoptotic index in a cohort of uniformly treated patients with ampullary cancer treated with radical surgical excision. EXPERIMENTAL DESIGN The entry criteria were that the patients have a pathologic diagnosis of ampullary cancer which had been resected. Expression analysis for Cox-2 and Survivin was done by immunohistochemical staining. Apoptotic cells were identified by the terminal deoxyribonucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) method. RESULTS Thirty-nine tumor specimens from resected ampullary adenocarcinoma patients were included. By univariate analysis, overall survival was affected by Cox-2 expression and TUNEL staining (respectively, P = 0.0003 and 0.03). Survivin expression did not influence the overall survival in our patient population (P = 0.123). Patients' clinicopathologic features (gender, age, and T and N factors) did not influence outcome. In multivariate Cox regression analysis, Cox-2 expression (relative risk, 4.330; P = 0.005) was the only variable that significantly affected overall survival. CONCLUSIONS The results of the present article provide, for the first time, evidence that Cox-2 expression, but not Survivin expression, may represent a significant prognostic factor after surgical resection in patients affected by cancer of the ampulla of Vater. Further studies are required to determine whether Cox-2 inhibitors may be useful for the therapy or prevention of ampullary carcinoma.
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