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Annals of Oncology Advance Access published online on August 9, 2008
Annals of Oncology, doi:10.1093/annonc/mdn558
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Promyelocytic leukemia (PML) gene expression is a prognostic factor in ampullary cancer patients

B. Vincenzi1, D. Santini1, G. Perrone2, A. Russo3,*, V. Adamo4, S. Rizzo3, F. Castri5, A. Antinori6, R. Alloni7, P. F. Crucitti7, S. Morini8, C. Rabitti2, F. M. Vecchio5, P. Magistrelli6, R. Coppola7 and G. Tonini1

1 Department of Medical Oncology
2 Department of Surgical Pathology, University Campus Bio-Medico, Rome
3 Section of Medical Oncology, Department of Surgical and Oncology Sciences, Palermo University, Palermo
4 Medical Oncology and Integrated Therapies Unit, Policlinico Universitario G. Martino, Messina
5 Department of Surgical Pathology
6 Department of Surgery, Catholic University of the Sacred Heart
7 Department of Surgery
8 Department of Biomedical Researches, University Campus Bio-Medico, Rome, Italy

* Correspondence to: Prof. A. Russo, Interdepartmental Center of Research in Clinical Oncology, School of Medicine, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy. Tel: +39-091-6552500; Fax: +39-091-6554529; E-mail: lab-oncobiologia{at}usa.net

Background: Promyelocytic leukemia (PML) tumor suppressor gene plays a key role in acute PML pathogenesis but its involvement in pathogenesis and prognosis of solid cancers has not been defined yet.

Patients and methods: In all, 62 ampullary adenocarcinoma patients who underwent curative surgery between 1996 and 2005 were included. Expression analysis of PML was carried out by immunohistochemical staining and correlated with disease-free survival (DFS) and overall survival (OS).

Results: In 24 tumor specimens (38.7%), PML was classified as absent, in 16 (25.8%) as focally expressed and in 22 (35.5%) as diffusely expressed. By univariate analysis, DFS was significantly influenced by pathological T stage (P = 0.03), lymph nodal involvement (P = 0.002), and PML expression (P = 0.001). DFS in patients without PML expression was 28.0 months versus 45.1 and 75.5 for patients with focal and diffuse expression, respectively. OS in the group of patients without PML expression, with focal expression, and with diffuse expression was 40, 48, and 77 months, respectively (P = 0.002). By a multivariate analysis, PML expression was the strongest prognostic factor for DFS (P = 0.003) and the only statically significant prognostic factor for OS (P = 0.009).

Conclusions: Our preliminary data suggest PML as a novel prognostic tool for ampullary cancer patients.

ampullary cancer, PML, survival

Received for publication May 9, 2008. Revision received July 11, 2008. Accepted for publication July 14, 2008.


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