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AmpuIIary cancer

机译：淋巴癌

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Purpose of review This manuscript reviews the recent literature on ampullary cancer, including new staging definitions, histological characteristics and treatment options. Recent findings Recent publications emphasize the importance of the histological differentiation (intestinal vs. pancreatobiliary), which is one of the most important prognostic factors for ampullary cancer. These histological subtypes can be differentiated by immunohistochemistry: while positivity for mucin-2 (MUC2) and caudal homeobox gene transcription factor-2 (CDX2) excludes the pancreatobiliary subtype, positivity for MUC1 and cytokeratin-17 (CK17) excludes the intestinal subtype. Also, different mechanisms of cancer development have been described, which might be related to the type of differentiation. Due to the very low risk of lymphatic spread, local resections appear sufficient for well differentiated T1 cancer smaller than 1 cm, whereas larger, less differentiated or more invasive cancer requires a radical resection. As cancer with intestinal differentiation shares a similar biology with colon cancer, and the pancreatobiliary differentiation is close to ductal adenocarcinoma of the pancreas, adjuvant chemotherapy should probably be given according to colon cancer (intestinal) and pancreatic cancer (pancreatobiliary), respectively. However, randomized trials are lacking. Summary The recent research suggests that the histological differentiation of periampullary cancer is more important than the anatomical location (ampulla). Future studies are required to take this emerging issue into account.
机译：审查目的本手稿回顾了壶腹癌的最新文献，包括新的分期定义，组织学特征和治疗选择。最近的发现最近的出版物强调了组织学分化的重要性（肠道与胰胆管癌），这是壶腹癌最重要的预后因素之一。这些组织学亚型可以通过免疫组织化学来区分：粘蛋白2（MUC2）和尾部同源盒基因转录因子2（CDX2）的阳性排除胰腺胆道亚型，而MUC1和细胞角蛋白17（CK17）的阳性排除肠道亚型。而且，已经描述了癌症发展的不同机制，这可能与分化的类型有关。由于淋巴扩散的风险非常低，局部切除似乎足以治疗高度小于1 cm的高分化T1癌，而较大，低分化或浸润性强的癌症则需要进行根治性切除。由于具有肠道分化的癌症与结肠癌具有相似的生物学特性，并且胰腺胆管分化接近胰腺的导管腺癌，因此可能应分别根据结肠癌（肠）和胰腺癌（胰腺胆管）给予辅助化疗。但是，缺乏随机试验。总结最近的研究表明壶腹周围癌的组织学分化比解剖部位（壶腹）更重要。需要进一步的研究来考虑这个新出现的问题。

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