{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T10:16:47Z","timestamp":1775643407768,"version":"3.50.1"},"reference-count":32,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2005,3,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Adenocarcinomas of the ampulla of Vater demonstrate a characteristic histology but vary significantly in outcome. As a consequence, prognostic factors for these cancers are poorly defined. The caudal-type homeodomain transcription factors 1 (CDX1) and 2 (CDX2) regulate axial development and intestinal differentiation. We assessed the expression of these putative intestinal epithelial-specific transcription factors and their influence on patient outcome. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Fifty-three resected carcinomas of the ampulla of Vater, 31 pancreatic ductal adenocarcinomas, and 15 extrahepatic biliary carcinomas were analyzed for CDX1 and CDX2 expression using immunohistochemistry. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Forty percent of carcinomas of the ampulla of Vater but less than 5% of pancreatic and biliary adenocarcinomas expressed CDX. Expression of CDX was associated with a better prognosis (P = .0009). Individually, both CDX1 (P = .02) and CDX2 (P = .02) expression were associated with a survival advantage on univariate analysis. Advanced T stage (P = .02), lymph node metastases (P = .004), and vascular space invasion (P = .0009) were associated with a poor prognosis. Multivariate analysis revealed vascular space invasion (P = .01) and CDX expression (P = .01) to be independent prognostic factors. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Expression of CDX was an independent marker of outcome in patients with resected adenocarcinoma of the ampulla of Vater. Expression of CDX may distinguish good prognosis intestinal-like tumors, which potentially arise within intestinal epithelium, from poorer prognosis pancreatobiliary tumors, which arise in adjacent pancreatic and\/or biliary ductal epithelium. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2005.03.068","type":"journal-article","created":{"date-parts":[[2005,3,18]],"date-time":"2005-03-18T04:26:08Z","timestamp":1111119968000},"page":"1811-1818","source":"Crossref","is-referenced-by-count":50,"title":["Expression of the Caudal-Type Homeodomain Transcription Factors <i>CDX<\/i> 1\/2 and Outcome in Carcinomas of the Ampulla of Vater"],"prefix":"10.1200","volume":"23","author":[{"given":"Donna E.","family":"Hansel","sequence":"first","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anirban","family":"Maitra","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Goggins","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedram","family":"Argani","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles J.","family":"Yeo","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Piantadosi","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven D.","family":"Leach","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew V.","family":"Biankin","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology, Surgery, Oncology, and Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199806000-00005"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1024\/1023-9332.5.1.11"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1080\/11024159950189375"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(00)00405-0"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.2001.1162"},{"key":"R6","unstructured":"Willett CG, Warshaw AL, Convery K, et al: Patterns of failure after pancreaticoduodenectomy for ampullary carcinoma. 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