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Analysis Study Research Paper | Pathology | Volume 15 Issue 1, January 2026 | Pages: 1759 - 1767 | India
Sub Classification of Periampullary Carcinoma in Whipple?s Specimen Received Using Immunohistochemistry Markers Mucin1 (MUC1), Cytokeratin 20 (CK20) & Caudal Type Homeodomain Transcription Factor (CDX2) - A Tertiary Care Study
Abstract: Background: Periampullary carcinoma (PAC) is a rare malignancy arising near the ampulla of Vater. Accurate histological subtyping into intestinal (INT), pancreatobiliary (PB), and mixed types is crucial for prognosis and therapeutic guidance. Morphological classification often lacks consistency, making immunohistochemistry (IHC) a vital tool. Objective: To subclassify PACs from Whipple?s specimens using IHC markers-MUC1, CK20, and CDX2-and assess their clinicopathological significance. Methods: A retro-prospective observational study was conducted from April 2023 to October 2024 at G.R. Medical College, Gwalior. Thirty Whipple?s specimens diagnosed with PAC were evaluated. IHC staining for MUC1, CK20, and CDX2 was performed. Tumors were subtyped as INT, PB, or mixed based on marker expression. Data were analyzed using SPSS v26 with p<0.05 as significant. Results: Most tumors were well-differentiated (56.67%) and G1 grade (60%), with significant p-values (0.0012, 0.0007). Vascular invasion was present in 23.34% (p = 0.0035). CDX2 and MUC1 positivity were observed in 66.67% and 80%, respectively. PB histological subtype predominated (53.34%). IHC-based classification showed PB in 46.67%, mixed in 33.33%, and INT in 20%. Conclusion: IHC markers MUC1, CK20, and CDX2 enhance the diagnostic precision of PAC subtyping, aiding prognosis and treatment decisions. PB subtype was most frequent and associated with aggressive features.
Keywords: Periampullary carcinoma, Immunohistochemistry, MUC1, CDX2, CK20
How to Cite?: Dr. Shazli Qureshi, Dr. Sudha Iyengar, Dr. Reena Jain, Dr. Ashish Shrivastava, "Sub Classification of Periampullary Carcinoma in Whipple?s Specimen Received Using Immunohistochemistry Markers Mucin1 (MUC1), Cytokeratin 20 (CK20) & Caudal Type Homeodomain Transcription Factor (CDX2) - A Tertiary Care Study", Volume 15 Issue 1, January 2026, International Journal of Science and Research (IJSR), Pages: 1759-1767, https://www.ijsr.net/getabstract.php?paperid=MR26128003755, DOI: https://dx.dx.doi.org/10.21275/MR26128003755