{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:21:27Z","timestamp":1791192087102,"version":"4.1.0"},"reference-count":54,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2011,7,13]]},"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Carcinomas of the Vaterian system are rare and presumably arise from pre-existing adenomas. According to the cancer stem cell (CSC) hypothesis, only a small subset of tumor cells has the ability to initiate and develop tumor growth. In colorectal cancer, CD44, CD133, CD166 and EpCAM have been proposed to represent CSC marker proteins and their expression has been shown to correlate with patient survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To evaluate a potential role of these CSC proteins in tumors of the ampulla of Vater, we investigated their expression in 175 carcinoma, 111 adenoma and 152 normal mucosa specimens arranged in a Tissue Microarray format.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>Membranous immunoreactivity for each protein marker was scored semi-quantitatively by evaluating the number of positive tumor cells over the total number of tumor cells. Median protein expression levels were used as cut-off scores to define protein marker positivity. Clinical data including survival time were obtained by retrospective analysis of medical records, tumor registries or direct contact.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The expression of all evaluated marker proteins differed significantly between normal mucosa, adenoma and carcinoma samples. In all markers, we found a tendency towards more constant expression from normal to neoplastic tissue. EpCAM expression was significantly correlated with better patient survival. The increased expression of CD44s, CD166 and CD133 from normal mucosa samples to adenoma and carcinoma was linked to tumor progression. However, there was no statistically significant correlation with survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our findings indicate, that in ampullary carcinomas, loss of expression of EpCAM may be linked to a more aggressive tumor phenotype.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jclinpath-2011-200043","type":"journal-article","created":{"date-parts":[[2011,12,2]],"date-time":"2011-12-02T01:39:24Z","timestamp":1322789964000},"page":"140-145","source":"Crossref","is-referenced-by-count":25,"title":["Effect of EpCAM, CD44, CD133 and CD166 expression on patient survival in tumours of the ampulla of Vater"],"prefix":"10.1136","volume":"65","author":[{"given":"Salvatore","family":"Piscuoglio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank S","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inti","family":"Zlobec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Tornillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Dietmaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arndt","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H","family":"W\u00fcnsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Sessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"R\u00fcmmele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Baumhoer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi M","family":"Terracciano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2011,11,30]]},"reference":[{"key":"2025092505511288000_65.2.140.1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1012982"},{"key":"2025092505511288000_65.2.140.2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800741025"},{"key":"2025092505511288000_65.2.140.3","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-006-0109-4"},{"key":"2025092505511288000_65.2.140.4","unstructured":"Brennan MF . Surgical management of peripancreatic cancer. In: Bland KL Karakoukis CP Copeland EM , eds. Atlas of Surgical Oncology. Philadelphia, PA: WB Saunders Company, 1995:473."},{"key":"2025092505511288000_65.2.140.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-004-0898-3"},{"key":"2025092505511288000_65.2.140.6","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/00042737-200012010-00014","article-title":"Cancer of the ampulla of Vater: results of a 20-year population-based study","volume":"12","author":"Benhamiche","year":"2000","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025092505511288000_65.2.140.7","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21374"},{"key":"2025092505511288000_65.2.140.8","unstructured":"Wright NH Howe JR Rossini FP . Tumours of the small intestine. In: Hamilton SR Aaltonen LA , eds. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Digestive System. IARC, 2000:69\u00e2\u0080\u009392."},{"key":"2025092505511288000_65.2.140.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7498-x"},{"key":"2025092505511288000_65.2.140.10","unstructured":"Albores-Saavedra J Henson DE Klimstra DS . Tumors of the Gallbladder, Extrahepatic Bile Ducts, and Ampulla of Vater. Washington, DC: Armed Forces Institute of Pathology, 2000:259\u00e2\u0080\u0093316."},{"key":"2025092505511288000_65.2.140.11","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-8-251"},{"key":"2025092505511288000_65.2.140.12","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199705000-00015"},{"key":"2025092505511288000_65.2.140.13","doi-asserted-by":"publisher","DOI":"10.1136\/gut.40.3.350"},{"key":"2025092505511288000_65.2.140.14","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-8-170"},{"key":"2025092505511288000_65.2.140.15","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-007-0444-1"},{"key":"2025092505511288000_65.2.140.16","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1827.2003.01534.x"},{"key":"2025092505511288000_65.2.140.17","first-page":"1841","article-title":"Cancers of the papilla of Vater: mutator phenotype is associated with good prognosis","volume":"3","author":"Achille","year":"1997","journal-title":"Clin Cancer Res"},{"key":"2025092505511288000_65.2.140.18","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19980504)76:3<407::AID-IJC19>3.0.CO;2-7"},{"key":"2025092505511288000_65.2.140.19","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9098(200102)76:2<121::AID-JSO1022>3.0.CO;2-7"},{"key":"2025092505511288000_65.2.140.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcb.2005.07.004"},{"key":"2025092505511288000_65.2.140.21","doi-asserted-by":"publisher","DOI":"10.1038\/35102167"},{"key":"2025092505511288000_65.2.140.22","doi-asserted-by":"publisher","DOI":"10.1002\/path.2498"},{"key":"2025092505511288000_65.2.140.23","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605762"},{"key":"2025092505511288000_65.2.140.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90290-9"},{"key":"2025092505511288000_65.2.140.25","doi-asserted-by":"publisher","DOI":"10.1016\/0959-8049(95)00252-E"},{"key":"2025092505511288000_65.2.140.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(98)00177-4"},{"key":"2025092505511288000_65.2.140.27","doi-asserted-by":"publisher","DOI":"10.1038\/nature05372"},{"key":"2025092505511288000_65.2.140.28","doi-asserted-by":"publisher","DOI":"10.1038\/nature05384"},{"key":"2025092505511288000_65.2.140.29","first-page":"2111","article-title":"CD133 expression is not restricted to stem cells, and both CD133+ and CD133\u00e2\u0088\u0092 metastatic colon cancer cells initiate tumors","volume":"118","author":"Shmelkov","year":"2008","journal-title":"J Clin Invest"},{"key":"2025092505511288000_65.2.140.30","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-008-0669-7"},{"key":"2025092505511288000_65.2.140.31","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181983ef7"},{"key":"2025092505511288000_65.2.140.32","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2006.044537"},{"key":"2025092505511288000_65.2.140.33","doi-asserted-by":"publisher","DOI":"10.1136\/gut.46.6.842"},{"key":"2025092505511288000_65.2.140.34","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/nrc2499-c1","article-title":"On the abundance of EpCAM on cancer stem cells","volume":"9","author":"Gires","year":"2009","journal-title":"Nat Rev Cancer"},{"key":"2025092505511288000_65.2.140.35","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603494"},{"key":"2025092505511288000_65.2.140.36","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/bgq187"},{"key":"2025092505511288000_65.2.140.37","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.10270"},{"key":"2025092505511288000_65.2.140.38","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2007.049460"},{"key":"2025092505511288000_65.2.140.39","doi-asserted-by":"publisher","DOI":"10.1309\/H8JEEAEB69J3KYND"},{"key":"2025092505511288000_65.2.140.40","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-03-0528"},{"key":"2025092505511288000_65.2.140.41","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-6-165"},{"key":"2025092505511288000_65.2.140.42","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/sj.bjc.6602310","article-title":"Cellular and complement-dependent cytotoxicity of Ep-CAM-specific monoclonal antibody MT201 against breast cancer cell lines","volume":"92","author":"Prang","year":"2005","journal-title":"Br J Cancer"},{"key":"2025092505511288000_65.2.140.43","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-04-0425"},{"key":"2025092505511288000_65.2.140.44","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1080\/13651820601090646","article-title":"Frequency and prognostic significance of occult tumor cells in lymph nodes in patients with adenocarcinoma of the papilla of Vater","volume":"9","author":"Scheunemann","year":"2007","journal-title":"HPB (Oxford)"},{"key":"2025092505511288000_65.2.140.45","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2006.037333"},{"key":"2025092505511288000_65.2.140.46","doi-asserted-by":"publisher","DOI":"10.1038\/ncb1824"},{"key":"2025092505511288000_65.2.140.47","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/S0002-9440(10)65297-2","article-title":"Expression of CD44 in Apc and Tcf mutant mice implies regulation by the WNT pathway","volume":"154","author":"Wielenga","year":"1999","journal-title":"Am J Pathol"},{"key":"2025092505511288000_65.2.140.48","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605839"},{"key":"2025092505511288000_65.2.140.49","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9088-1"},{"key":"2025092505511288000_65.2.140.50","first-page":"1071","article-title":"The significance of CD44 expression in gastrointestinal neuroendocrine tumors","volume":"52","author":"Lai","year":"2005","journal-title":"Hepatogastroenterology"},{"key":"2025092505511288000_65.2.140.51","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.016238"},{"key":"2025092505511288000_65.2.140.52","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.2008.00849.x"},{"key":"2025092505511288000_65.2.140.53","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604664"},{"key":"2025092505511288000_65.2.140.54","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1002\/ijc.24822","article-title":"CD133 is indicative for a resistance phenotype but does not represent a prognostic marker for survival of non-small cell lung cancer patients","volume":"126","author":"Salnikov","year":"2010","journal-title":"Int J Cancer"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2011-200043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:51:20Z","timestamp":1758804680000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2011-200043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,11,30]]},"references-count":54,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2012,1,19]]},"published-print":{"date-parts":[[2012,2]]}},"alternative-id":["10.1136\/jclinpath-2011-200043"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2011-200043","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,11,30]]}}}