The prognostic role of epidermal growth factor receptor mutation in completely resected ampullary adenocarcinoma.

Abstract

Theaim ofthis study is to make adifferential diagnosis and prognosis oftheampullary adenocarcinoma subtypes. We also investigated therole ofprognostic markers PD-1 and PD-L1, and epidermal growth factor receptor (EGFR). Local or locally advanced stage ampullary adenocarcinoma patients who had undergone pancreaticoduodenectomy at thetime ofdiagnosis were included. MUC1, MUC2, MUC5AC, CDX2, CK7, CK20, PD-1, and PDL-1 were analysed immunohistochemically, and EGFR was analysed by real-time polymerase chain reaction. According to histopathological and immunohistochemical evaluation, we found 27 patients as pancreatobiliary type and 56 patients as intestinal type adenocarcinoma. Themedian survival ofpatients with intestinal and pancreatobiliary type adenocarcinoma was 23 months and 76 months ( p = 0.201), respectively. When thesurvival ofPD1-positive ( n = 23) and PD-L1-positive ( n = 18) patients were compared with thepatients with negative staining ( n = 60, n = 65), no significant difference was found. Epidermal growth factor receptor mutation was detected in atotal of6 patients, and 5 ofthese 6 mutations were shown in intestinal type tumours and one in apancreatobiliary type tumour. Asignificant difference was determined in terms ofoverall survival for thepatients with EGFR mutations compared to those without ( p = 0.008). In conclusion, we could reveal theprognostic significance ofEGFR mutation, which is also atarget molecule.