A different perspective to the tumor microenvironment in periampullary cancers: a neglected ring in tumorogenesis.

Aim: There is increasing evidence that, tumor microenvironment plays an important role in the initiation and progression of the tumor and is not only a passive observer. In this study the immunohistochemical staining pattern of the stromal cells in tumor microenvironment which is rarely discussed in the literature, has been demonstrated by considering p53 and HSF1 which are important molecular proteins in tumorogenesis. Material and Method: Sixty-nine pancreaticoduodenectomy specimens that performed between 2000 and 2012 were re-evaluated in terms of HSF1/P53 expressions in tumor microenvironment and tumoral cells. The findings were statistically analyzed. Results: In our study, there was a significant difference between tumoral microenvironment and tumoral cells in terms of HSF1 staining (p<0.05). For P53, this difference was observed in pancreatic carcinomas (p<0.05), whereas were not observed in ampullary region carcinomas (p>0.05). Conclusions: Significant staining of two well-known immunomarkers, such as P53 and HSF1, in stromal cells has further increased the importance of tumor microenvironment in tumorogenesis