In the bile duct and ampullary carcinoma cohort calpain-1 had a median H-score of 100 and ranged from 0 to 270; calpain-2 had a median H-score of 50 and ranged from 0 to 200; cytoplasmic calpastatin expression had a median H-score of 137 and ranged from 0 to 300 and nuclear calpastatin expression had a median H-score of 20 and ranged from 0 to 210. This evidence concerns the gene CAST and carcinoma of the ampulla of vater.