| 摘要 |
The carcinoma of the ampulla of Vater is the second most common periampullary
cancer and also the most common neoplasm of the small intestine. In previous
studies, the 5-year survival rate of patients with carcinoma of the ampulla of Vater
ranged from 38.0 to 67.7% after pancreaticoduodenectomy. Lymph node
involvement, poor differentiation, pancreatic invasion and tumor stage were
predictors of a poor prognosis. Results vary among institutions and postoperative
adjuvant chemoradiotherapy does not improve long-term survival after radical
surgery. Also, in reports from the Surveillance, Epidemiology, and End Results
(SEER) program in the United States, the resection rate of ampullary cancer was
only 40% and 5-year survival was 36.8% in this large cohort study. From this
unbiased registry data, the prognosis of ampullary carcinoma after radical resection
is fair and additional treatment modalities are needed to improve survival.
The adenoma to carcinoma sequence raises suspicion of carcinoma of the ampulla of
Vater. In the carcinogenesis of ampullary carcinoma, possible mechanisms involve
include tumor suppressors, oncogenes, DNA replication, cell cycle regulation, growth
factors, the cytoskeleton and cell adhesion, among others. Nevertheless, the
mechanism, which appears to be complex, remains obscure. Further efforts are
needed to elucidate the mechanism and to improve the survival of patients with
ampullary carcinoma. |
