Expression of Bcl-2 19-kDa interacting protein 3 predicts prognosis after ampullary carcinoma resection

Background An adequate management strategy for ampullary carcinoma (AC), a rare neoplasm, has yet to be determined. The aim of this study was to identify specific molecular markers allowing for the adequate management of AC. Methods The clinicopathological data of 41 patients who underwent curative resection of AC were reviewed retrospectively. The expression of thymidylate synthase (TS) and Bcl‐2 19‐kDa interacting protein 3 (BNIP3), two sensitive markers for S‐1 and gemcitabine, respectively, was evaluated immunohistochemically. The relationship between the expression levels of these markers and the clinicopathological data were then investigated. Results The 5‐year overall survival rate in the study population was 62%. In univariate and multivariate analyses, lymph node metastasis, neural invasion, lymphatic invasion, and the high‐level BNIP3 expression were significant predictive factors for a poor postoperative prognosis. Neither TS nor BNIP3 expression were able to predict survival or the disease recurrence rate in patients who received postoperative adjuvant chemotherapy for AC. Conclusions BNIP3 expression may serve as a prognostic marker for patients with AC, but neither TS nor BNIP3 contributes to the selection criteria for adjuvant chemotherapy for AC, at least with respect to current drug regimens. Highlight Aiming to establish an adequate management strategy for this rare neoplasm, Fujimoto and colleagues demonstrated that expression of Bcl‐2 19‐kDa interacting protein 3 (BNIP3), a sensitive marker for gemcitabine, may serve as a prognostic marker for ampullary carcinoma, although it does not contribute to the selection criteria for adjuvant chemotherapy.