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Shvero A, Hilly O, Bubis G, Hamzany Y, Koren R, Rath-Wolfson L. Expression of Topoisomerase II-α protein in salivary gland tumors. Mol Clin Oncol 2017; 7:1064-1068. [PMID: 29285375 DOI: 10.3892/mco.2017.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 10/18/2017] [Indexed: 11/05/2022] Open
Abstract
Salivary glands give rise to approximately 30 histological distinct tumor types, which results in a diagnostic challenge for the pathologist. The present retrospective, immunohistochemical study aimed to evaluate the expression of Topoisomerase II-α, a nuclear enzyme, as a diagnostic and prognostic marker in benign and malignant salivary gland tumors, including leomorphic adenoma, mucoepidermoid carcinoma, acinic cell carcinoma and carcinoma ex-pleomorphic adenoma. A total of 59 cases of benign and malignant salivary gland tumors were included in the present study. Representative paraffin-embedded sections were immunostained for Topoisomerase II-α (Topo II-α). The expression level was semi-quantified for each case and then correlated with the histological diagnosis using hematoxylin and eosin-stained slides, grade of tumor and total survival. Significant differences were revealed between the expression level of Topo II-α in pleomorphic adenoma and mucoepidermoid carcinoma (P<0.001), carcinoma ex-pleomorphic adenoma (P<0.001), acinic cell carcinoma (P=0.005) and a group composed of all the malignant tumors (P<0.001). Cancer-specific survival rates were insignificantly increased in tumors expressing low levels of Topo II-α (P=0.464). Thus, the present study demonstrated different expression levels of Topo II-α in benign and malignant salivary gland tumors. These differing expression levels may act as valuable biomarkers for the correct histological diagnosis. Further studies conducted on a larger scale may lead to even more conclusive results.
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Affiliation(s)
- Asaf Shvero
- Department of Urology, Sheba Medical Center, Tel Hashomer, Israel.,Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Ohad Hilly
- Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel.,Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Golan Bubis
- St. George's University of London, University of Nicosia, Nicosia, Cyprus
| | - Yaniv Hamzany
- Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel.,Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Rumelia Koren
- Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel.,Department of Pathology, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Lea Rath-Wolfson
- Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel.,Department of Pathology, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel
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Freitas LLL, Araújo VC, Martins MT, Chone C, Crespo A, Altemani A. Biomarker Analysis in Carcinoma ex Pleomorphic Adenoma at an Early Phase of Carcinomatous Transformation. Int J Surg Pathol 2016; 13:337-42. [PMID: 16273189 DOI: 10.1177/106689690501300405] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Diagnostic criteria for intracapsular carcinoma ex pleomorphic adenoma (CXPA) are subjective and vary among authors. Biomarker analysis, which could provide more objective evaluation of these tumors, has rarely been studied in intracapsular CXPA. Immunohistochemical evaluation of c-erbB-2, p53 protein, bcl-2, and Ki-67 was performed in 8 cases of CXPA at an early phase of malignant transformation (4 intracapsular and 4 minimally invasive) and in 17 pleomorphic adenomas (PA). In all cases of CXPA, p53 and Ki-67 were demonstrated predominantly in luminal cells of benign and malignant areas, significantly more in the latter. Few benign myoepithelial cells were p53 positive. c-erbB-2 reactivity was strongly associated with atypical luminal cells. Bcl-2 expression was weak and focal in malignant areas from 2 cases. In conclusion, both p53 and c-erbB-2 proteins appear to be involved at an early stage of malignization of PA. In PA with atypical cells, evaluation of the expression of these 2 markers provides more objective criteria for the diagnosis of intracapsular CXPA.
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Affiliation(s)
- Leandro L L Freitas
- Department of Pathology, Medical Science Faculty, University of Campinas (UNICAMP), Campinas, SP, Brazil
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Sedassari BT, Rodrigues MFSD, Mariano FV, Altemani A, Nunes FD, Sousa S. The Stem Cell Marker Bmi-1 Is Sensitive in Identifying Early Lesions of Carcinoma ex Pleomorphic Adenoma. Medicine (Baltimore) 2015; 94:e1035. [PMID: 26166073 PMCID: PMC4504655 DOI: 10.1097/md.0000000000001035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
In the present study, we evaluated and described the sensitivity of the stem cell marker B cell-specific moloney murine leukemia virus integration site 1 (Bmi-1) in identifying early lesions of carcinoma ex pleomorphic adenoma (CXPA). While invasive CXPAs are tumors with a prominent and easily recognizable malignant component, the identification of early carcinomatous changes in PA remains a diagnostic challenge due to the lack of objective morphological criteria. The immunohistochemical expression of Bmi-1 was assessed in both adenomatous and carcinomatous components of 9 CXPA cases at an early phase of histological progression (6 intracapsular and 3 minimally invasive) grouped according to the cellular differentiation as luminal (7 cases) or myoepithelial (2 cases). A selective nuclear expression of Bmi-1 was found exclusively in the malignant component of 8 cases (6 luminal type and 2 myoepithelial type), including intraductal carcinoma areas, except for 1 case in which scarce cells of the remnant PA were positive. Thus, Bmi-1 is expressed from the earliest morphologically detectable stages of PA malignant transformation. When faced with atypical features in PA, evaluation of Bmi-1 expression can provide more objective criteria for identification and diagnosis of early lesions of CXPA. This is applied to carcinomas with luminal or myoepithelial differentiation.
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Affiliation(s)
- Bruno Tavares Sedassari
- From the Department of Oral and Maxillofacial Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil (BTS, MFSDR, FDN, SS); and Department of Anatomic Pathology, School of Medicine, State University of Campinas, São Paulo, Brazil (FVM, AA)
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Alaizari NA, Tarakji B, Al-Maweri SA, Al-Shamiri HM, Darwish S, Baba F. p53 expression in pleomorphic adenoma of salivary glands: A systematic review and meta-analysis. Arch Oral Biol 2015; 60:1437-41. [PMID: 26163983 DOI: 10.1016/j.archoralbio.2015.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/29/2015] [Accepted: 06/15/2015] [Indexed: 01/10/2023]
Abstract
OBJECTIVE There are conflicting data regarding immunohistochemical expression of p53 in pleomorphic adenoma. This systematic review and meta-analysis aimed to examine whether p53 expression has a role in the pathogenesis of pleomorphic adenoma. DESIGN A comprehensive literature search for relevant studies published from 2000 up to end of 2014 was performed using PubMed, EMBASE and the Cochrane Library Databases. Only articles in which p53 detected by immunohistochemical staining were included. The meta-analysis was done using Comprehensive Meta-Analysis software. RESULTS Eighteen eligible studies were included in this meta-analysis. Heterogeneity measures showed a statistically significant Cochrane Q value (P-value<0.001). The random effects model showed an effect size of 0.254 with a 95% CI (0.139-0.417). The overall p53 positivity is 25.4%. CONCLUSION Mutant p53 has to be detected by more precise techniques to emphasize on its role in development of pleomorphic adenoma of salivary gland.
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Affiliation(s)
- Nader Ahmed Alaizari
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia; Department of Oral Medicine and Pathology, Faculty of Dentistry, Sana'a University, Yemen.
| | - Bassel Tarakji
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Sadeq Ali Al-Maweri
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia; Department of Oral Medicine and Pathology, Faculty of Dentistry, Sana'a University, Yemen
| | - Hashem Motahir Al-Shamiri
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Shourouk Darwish
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Feras Baba
- Aleppo University, Faculty of Dentistry, Syria
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Bagulkar BB, Gawande M, Chaudhary M, Gadbail AR, Patil S, Bagulkar S. XIAP and Ki-67: A Correlation Between Antiapoptotic and Proliferative Marker Expression in Benign and Malignant Tumours of Salivary Gland: An Immunohistochemical Study. J Clin Diagn Res 2015; 9:EC01-4. [PMID: 25859460 DOI: 10.7860/jcdr/2015/11690.5604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/14/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Impaired balance between cell proliferation and apoptosis is crucial to the development of malignant neoplasm. The purpose of this study was to evaluate and compare the expression of X-Linked inhibitor of apoptotic protein (XIAP) (antiapoptotic marker) and Ki-67 (proliferative marker) expression in benign and malignant salivary gland (SG) tumours. MATERIALS AND METHODS The study consisted of 40 cases of benign SG tumours and 50 cases of malignant SG tumours. The immunohistochemistry was carried out by using Ki-67 antibody (clone MIB-1) and XIAP antibody in all the groups. RESULTS XIAP expression was significantly higher in malignant SG tumours than benign SG tumours (p = 0.016). Ki-67 LI was significantly higher in malignant SG tumours than benign SG tumours (p = 0.0002). Statistically significant positive correlation between Ki-67 count and XIAP expression was noted in benign and malignant SG tumours (p = 0.000). CONCLUSION As the expression of an antiapoptotic marker (XIAP) increases, the expression of a proliferative marker (Ki-67) also increases from benign to malignant SG tumours. Thus, targeted therapy of XIAP may play a future role in the management of SG malignancy.
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Affiliation(s)
- Bhupesh Bhayyaji Bagulkar
- Assistant Professor, Department of Oral and Maxillofacial Pathology and Microbiology, Sri Aurobindo College of Dentistry , Indore, Madhya Pradesh, India
| | - Madhuri Gawande
- Professor, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences , Sawangi (M), Wardha, Maharashtra, India
| | - Minal Chaudhary
- Professor and Head, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences , Sawangi (M), Wardha, Maharashtra, India
| | - Amol Ramchandra Gadbail
- Associate Professor, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences , Sawangi (M), Wardha, Maharashtra, India
| | - Swati Patil
- Professor, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (M) , Wardha, Maharashtra, India
| | - Smita Bagulkar
- Lecturer, Department of Oral and Maxillofacial Surgery, Sri Aurobindo College of Dentistry , Indore, Madhya Pradesh, India
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Wallace AS, Morris CG, Kirwan JM, Werning JW, Mendenhall WM. Radiotherapy for pleomorphic adenoma. Am J Otolaryngol 2013; 34:36-40. [PMID: 22959365 DOI: 10.1016/j.amjoto.2012.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 08/01/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of this study was to update our experience in treating pleomorphic adenoma with radiotherapy (RT). MATERIALS AND METHODS This is a retrospective analysis of 25 patients treated with RT alone (2 patients) or combined with surgery (23 patients), with follow-up ranging from 1.8 to 34.9 years (median, 10.5 years). RESULTS Local control was achieved in 13 (75%) of 16 patients with subclinical disease and 5 (56%) of 9 patients with gross disease. Overall local control was achieved in 18 (72%) of 25 patients. The 5-, 10-, and 15-year overall local control rates were 76 %, 76%, and 68%, respectively. Ten patients died of the following causes: recurrent disease, 2; malignant transformation, 2; and intercurrent disease, 6. At last follow-up, 14 patients were alive without evidence of disease, and 1 patient was alive with disease. Dental carries and transient facial nerve deficits were the most common complications. No patients developed severe complications subsequent to RT. CONCLUSIONS In patients at high risk for developing recurrent pleomorphic adenoma after surgery, RT is effective in controlling subclinical disease.
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Soares AB, Altemani A, de Araújo VC. Study of histopathological, morphological and immunohistochemical features of recurrent pleomorphic adenoma: an attempt to predict recurrence of pleomorphic adenoma. J Oral Pathol Med 2010; 40:352-8. [PMID: 20969626 DOI: 10.1111/j.1600-0714.2010.00956.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Recurrent pleomorphic adenoma (RPA) is an uncommon and challenging disease. The aim of this study was to review the clinical information obtained by examining RPA patients, to determine its histomorphological features and to verify the expression of the Mcm-2 markers of cell proliferation and the expression of p-53 in pleomorphic adenoma (PA), RPA, and RPA with malignant transformation (TRPA). METHODS A total of 10 cases of PA and 29 cases of RPA were examined in detail for the presence of nodules and their histomorphological features. Cell proliferation and expression of p-53 were detected by the immunohistochemical technique using the antibodies against Mcm-2 and p-53. RESULTS Histopathologically, RPA is very similar to PA; the only difference found was that all the cases of RPA were multinodular. When comparing primary and recurrent tumor, no significant difference was found in terms of cell proliferation and the expression of p-53; however, in the RPA with areas of malignant transformation there was an increased expression of these proteins. CONCLUSION This study showed that recurrences were multinodular, with nodules varying in numbers and sizes. No significant difference in histological features was found between RPA and PA. Moreover, the immunohistochemical study showed a low expression of p-53 and Mcm-2 in PA and RPA and an increased expression of these proteins in the RPA with areas of malignant transformation.
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AL-Rawi NH, Omer H, AL Kawas S. Immunohistochemical analysis of P53and bcl-2 in benign and malignant salivary glands tumors. J Oral Pathol Med 2010; 39:48-55. [DOI: 10.1111/j.1600-0714.2009.00816.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maruyama S, Cheng J, Shingaki S, Tamura T, Asakawa S, Minoshima S, Shimizu Y, Shimizu N, Saku T. Establishment and characterization of pleomorphic adenoma cell systems: an in-vitro demonstration of carcinomas arising secondarily from adenomas in the salivary gland. BMC Cancer 2009; 9:247. [PMID: 19622142 PMCID: PMC2722671 DOI: 10.1186/1471-2407-9-247] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Accepted: 07/21/2009] [Indexed: 01/01/2023] Open
Abstract
Background Among the salivary gland carcinomas, carcinoma in pleomorphic adenoma has been regarded as a representative carcinoma type which arises secondarily in the background of a pre-existent benign pleomorphic adenoma. It is still poorly understood how and which benign pleomorphic adenoma cells transform into its malignant form, carcinoma ex pleomorphic adenoma. Methods We have established five cell systems from a benign pleomorphic adenoma of the parotid gland of a 61-year-old woman. They were characterized by immunofluorescence, classical cytogenetics, p53 gene mutational analysis, fluorescence in-situ hybridization, and histopathological and immunohistochemical examinations of their xenografts, to demonstrate their potency of secondary transformation. Results We established and characterized five cell systems (designated as SM-AP1 to SM-AP5) from a benign pleomorphic adenoma of the parotid gland. SM-AP1 to SM-AP3 showed polygonal cell shapes while SM-AP4 and SM-AP5 were spindle-shaped. SM-AP1-3 cells were immunopositive for keratin only, indicating their duct-epithelial or squamous cell differentiation, while SM-AP4/5 cells were positive for both keratin and S-100 protein, indicating their myoepithelial cell differentiation. Chromosome analyses showed numeral abnormalities such as 5n ploidies and various kinds of structural abnormalities, such as deletions, translocations, derivatives and isodicentric chromosomes. Among them, der(9)t(9;13)(p13.3;q12.3) was shared by all five of the cell systems. In addition, they all had a common deletion of the last base G of codon 249 (AGG to AG_) of the p53 gene, which resulted in generation of its nonsense gene product. Transplanted cells in nude mice formed subcutaneous tumors, which had histological features of squamous cell carcinoma with apparent keratinizing tendencies. In addition, they had ductal arrangements or plasmacytoid appearances of tumor cells and myxoid or hyaline stromata, indicating some characteristics of pleomorphic adenoma. Conclusion This study demonstrates in vitro that certain cell types from pleomorphic adenoma are able to clone and survive over a long term and develop subcutaneous tumors in nude mice. The histological features of squamous cell carcinoma from the transplanted cell systems in nude mice might suggest a secondary onset of malignancy from a pre-existing benign adenoma.
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Affiliation(s)
- Satoshi Maruyama
- Division of Oral Pathology, Department of Tissue Regeneration and Reconstruction, Niigata University, Graduate School of Medical and Dental Sciences, 2-5274 Gakkoucho-dori, Chuo-ku, Niigata 951-8514, Japan.
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Maruyama S, Cheng J, Yamazaki M, Liu A, Saku T. Keratinocyte growth factor colocalized with perlecan at the site of capsular invasion and vascular involvement in salivary pleomorphic adenomas. J Oral Pathol Med 2009; 38:377-85. [DOI: 10.1111/j.1600-0714.2008.00742.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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DeRoche TC, Hoschar AP, Hunt JL. Immunohistochemical evaluation of androgen receptor, HER-2/neu, and p53 in benign pleomorphic adenomas. Arch Pathol Lab Med 2009; 132:1907-11. [PMID: 19061288 DOI: 10.5858/132.12.1907] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT Immunohistochemical stains for androgen receptor (AR), HER-2/neu, and p53 are used as diagnostic markers associated with malignancy in several histologic types of salivary gland tumors. These markers may be useful in differentiating pleomorphic adenoma with cytologic atypia from intracapsular carcinoma ex pleomorphic adenoma (CXPA), as these tumors are often difficult to distinguish on the basis of morphology alone. OBJECTIVE To determine whether AR, HER-2/neu, and p53 expression can be seen in entirely benign pleomorphic adenomas. DESIGN Androgen receptor, HER-2/neu, and p53 immunoreactivity was assessed in 41 histologically and clinically benign pleomorphic adenomas. RESULTS A total of 3 of 41 pleomorphic adenomas exhibited multifocal areas with moderate staining for HER-2/ neu and AR. The positive staining was mainly confined to the epithelial component, where the ductal epithelium showed no cytologic atypia. Immunoreactivity for p53 was observed in the epithelial component of 5 of 41 cases, none of which stained for HER-2/neu and AR. Mean mitotic rate and Ki-67 index were 1 per 10 high-powered fields and 2.7% in HER-2/neu- and AR-positive cases and 1 per 10 high-powered fields and 2.2% in p53-positive cases. CONCLUSIONS HER-2/neu, AR, and p53 are expressed in a subset of histologically and clinically benign pleomorphic adenomas. These markers cannot be used to reliably predict early carcinomatous transformation in pleomorphic adenoma.
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Affiliation(s)
- Tom C DeRoche
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH 44195, USA
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Correlation between FDG-PET findings and GLUT1 expression in salivary gland pleomorphic adenomas. Ann Nucl Med 2008; 22:693-8. [DOI: 10.1007/s12149-008-0162-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Accepted: 05/14/2008] [Indexed: 10/21/2022]
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Hoch BL, Wu M, Lewis M, Gan L, Burstein DE. An immunohistochemical study of XIAP expression in pleomorphic adenoma and carcinoma ex pleomorphic adenoma. J Oral Pathol Med 2008; 37:634-8. [DOI: 10.1111/j.1600-0714.2008.00680.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Matsubayashi S, Yoshihara T. Carcinoma ex pleomorphic adenoma of the salivary gland: an immunohistochemical study. Eur Arch Otorhinolaryngol 2007; 264:789-95. [PMID: 17310348 DOI: 10.1007/s00405-007-0256-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 12/19/2006] [Indexed: 10/23/2022]
Abstract
The proliferative activity of the tumor cells and the expression of tumor-associated genes and sex steroid hormone receptors were investigated immunohistochemically in ten cases of carcinoma ex pleomorphic adenoma (Ca-ex-PA) of the salivary glands. These were analyzed in benign and malignant components separately, and then were compared with ten cases of the other malignant tumors [adenocarcinomas, not otherwise specified (ACN) and salivary duct carcinomas (SDC)] and ten cases of pleomorphic adenomas (PA). The results obtained in this study were as follows: (1) malignant component of Ca-ex-PA showed a higher incidence of PCNA and Ki67 than benign component of Ca-ex-PA. A significant difference between benign component of Ca-ex-PA and PA was not observed. (2) A significant difference in the incidence of p53, c-erbB-2, EGFR overexpression was observed only between malignant component of Ca-ex-PA and benign component of Ca-ex-PA. (3) The incidence of PCNA, Ki67, p53, c-erbB-2 overexpression in malignant component of Ca-ex-PA showed the highest data among the four groups. These results suggest that Ca-ex-PA acquired the particular biological behavior in contrast to the other salivary neoplasms in the long-standing process while PA undergoes malignant transformation.
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MESH Headings
- Adenoma, Pleomorphic/immunology
- Adenoma, Pleomorphic/metabolism
- Adenoma, Pleomorphic/pathology
- Aged
- Antibodies, Neoplasm/immunology
- Biomarkers, Tumor/immunology
- Biomarkers, Tumor/metabolism
- Carcinoma, Ductal/immunology
- Carcinoma, Ductal/metabolism
- Carcinoma, Ductal/pathology
- Diagnosis, Differential
- ErbB Receptors/immunology
- ErbB Receptors/metabolism
- Female
- Follow-Up Studies
- Humans
- Immunohistochemistry/methods
- Ki-67 Antigen/immunology
- Ki-67 Antigen/metabolism
- Male
- Middle Aged
- Neoplasm Recurrence, Local/immunology
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Proliferating Cell Nuclear Antigen/immunology
- Proliferating Cell Nuclear Antigen/metabolism
- Receptor, ErbB-2/immunology
- Receptor, ErbB-2/metabolism
- Receptors, Androgen/immunology
- Receptors, Androgen/metabolism
- Receptors, Estrogen/immunology
- Receptors, Estrogen/metabolism
- Retrospective Studies
- Salivary Gland Neoplasms/immunology
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
- Tumor Suppressor Protein p53/immunology
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- Saori Matsubayashi
- Department of Otolaryngology, Tokyo Women's Medical University, Tokyo, Japan
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Pannellini T, Spadaro M, Di Carlo E, Ambrosino E, Iezzi M, Amici A, Lollini PL, Forni G, Cavallo F, Musiani P. Timely DNA vaccine combined with systemic IL-12 prevents parotid carcinomas before a dominant-negative p53 makes their growth independent of HER-2/neu expression. THE JOURNAL OF IMMUNOLOGY 2006; 176:7695-703. [PMID: 16751417 DOI: 10.4049/jimmunol.176.12.7695] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Double transgenic mice overexpressing the transforming rat HER-2/neu oncogene and the mutated p53, with both dominant-negative and a gain-of-function properties, display early aggressive and metastasizing parotid tumors. Multiple acinar and ductal hyperplasia foci overexpressing the HER-2/neu gene product are evident at wk 5 and progress to poorly differentiated carcinoma by wk 7. Mice die before wk 18 with invasive carcinomas and multiple metastases that no longer express HER-2/neu. A combination of repeated electroporations of plasmids coding for the extracellular and transmembrane domains of the rat HER-2/neu receptor with systemic IL-12 administrations started when the parotids that present diffuse hyperplasia protected all female and 50% of the male mice until the close of the experiment at wk 40. This combined treatment began when multifocal in situ carcinomas that were already present cured 33% of the females and 25% of the males. The most prominent immunologic features associated with the antitumor protection were the production of high titers of anti-HER-2/neu Abs and the nonappearance of cell-mediated cytotoxic reactivity. In conclusion, anti-HER-2/neu vaccination combined with systemic IL-12 control parotid carcinomas as far as p53 mutation makes their growth independent of HER-2/neu expression.
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Affiliation(s)
- Tania Pannellini
- Aging Research Center, CeSi, G. d'Annunzio University Foundation, Chieti, Italy
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Ethunandan M, Witton R, Hoffman G, Spedding A, Brennan PA. Atypical features in pleomorphic adenoma—a clinicopathologic study and implications for management. Int J Oral Maxillofac Surg 2006; 35:608-12. [PMID: 16540285 DOI: 10.1016/j.ijom.2006.02.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2005] [Revised: 11/17/2005] [Accepted: 02/06/2006] [Indexed: 11/22/2022]
Abstract
Pleomorphic adenoma is the most common salivary gland neoplasm and infrequently undergoes malignant transformation. Carcinoma ex pleomorphic adenoma is typically an infiltrative neoplasm with features of cellular pleomorphism, high mitotic activity, peri-neural and vascular invasion. More recently, sub-groups of pleomorphic adenoma have been described exhibiting vascular invasion and features of malignancy without evidence of extra-capsular extension. There is little information in the literature regarding how these different histological variants influence clinical presentation and outcome following primary treatment. Following a review of 100 consecutive pleomorphic adenomas removed from the major salivary glands, 4 cases with atypical histological features were found. Three tumours exhibited features of dysplasia/carcinoma without evidence of extra-capsular invasion and a further case demonstrated benign vascular invasion. There were no clinical features suggestive of the atypical nature of these neoplasms, though fine needle aspiration cytology (FNAC) was suspicious of a malignancy in 2 cases and CT scan in 1 case. Patients underwent a superficial parotidectomy or submandibular gland excision based on the location of the lesion. All lesions were completely excised and there were no recurrences in this series.
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Affiliation(s)
- M Ethunandan
- Maxillofacial unit, Queen Alexandra Hospital, Portsmouth PO6 3LY, United Kingdom
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Silva SJD, Costa Junior GT, Brant Filho AC, Faria PR, Loyola AM. Metachronous bilateral pleomorphic adenoma of the parotid gland. ACTA ACUST UNITED AC 2006; 101:333-8. [PMID: 16504867 DOI: 10.1016/j.tripleo.2005.07.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Revised: 07/06/2005] [Accepted: 07/10/2005] [Indexed: 10/25/2022]
Abstract
Bilateral salivary gland tumors are very rare, accounting for 3% of all parotid gland tumors. Although the most common tumor with bilateral development is the Warthin tumor, pleomorphic adenomas (PA) have been diagnosed simultaneously as well, but in a smaller incidence. Because of this, the prevalence, etiology, pathogenesis, and behavior of the PA in this context are poorly understood. We present a case of bilateral metachronous PA affecting the parotid gland in a 63-year-old woman. Clinically, the lesions presented with similar aspects as seen in cases of solitary PA with slow-growing asymptomatic nodule. Both lesions were diagnosed by fine-needle aspiration biopsy at an interval of 2 years between them. A total and superficial parotidectomy for left and right tumors, respectively, was performed. Only on the left side some facial nerve branches were removed that induced partial paralysis in the patient. A review of the pertinent literature is included.
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Affiliation(s)
- Sindeval José da Silva
- Department of Head and Neck Surgery, University Hospital, School of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Di Palma S, Skálová A, Vanìèek T, Simpson RHW, Stárek I, Leivo I. Non-invasive (intracapsular) carcinoma ex pleomorphic adenoma: recognition of focal carcinoma by HER-2/neu and MIB1 immunohistochemistry. Histopathology 2005; 46:144-52. [PMID: 15693886 DOI: 10.1111/j.1365-2559.2005.02058.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIMS Non-invasive carcinoma ex pleomorphic adenoma is defined as a carcinoma arising within the boundaries of a pleomorphic adenoma (PA), but which fails to display invasion beyond the capsule of host PA. Alternative names are intracapsular, in situ, or focal carcinoma. The true nature of non-invasive carcinoma ex-PA is still controversial; for example, it is not clear whether it represents early but genuine carcinomatous changes with the genetic make-up of malignant cells, or simply cytological, possibly metaplastic or 'bizarre' changes in PA. Strong overexpression and amplification of HER-2/neu protein has recently been demonstrated in invasive carcinoma ex-PA. In addition, data from breast cancer studies suggest that amplification of HER-2/neu and overexpression of its gene product is mainly involved in the initiation of breast oncogenesis. We sought to establish whether this method could help to demonstrate that what is described as non-invasive carcinoma ex-PA is really a genuine malignancy, albeit in an early phase. METHODS AND RESULTS Eleven cases of non-invasive carcinoma (in situ) ex-PA were studied for HER-2/neu status using immunohistochemistry and fluorescent in-situ hybridization (FISH). Cells of focal non-invasive carcinoma ex-PA were strongly positive for HER-2/neu protein, while the cells of the maternal PA were always negative. Two cases of low-grade non-invasive myoepithelial carcinoma ex-PA were negative. In four cases out of a total of six tumours studied by FISH, we detected amplification of HER-2/neu gene signals in tumour cells of focal, non-invasive, carcinoma. CONCLUSIONS The current data suggest that non-invasive carcinoma ex PA is a genuine carcinoma within a PA. However, the presence of cyto-nuclear atypia is not sufficient to make a definite diagnosis of malignant change, which requires a combination of morphology and immunohistochemistry.
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Affiliation(s)
- S Di Palma
- Department of Histopathology, Royal Surrey County Hospital, University of Surrey, Guilford, UK.
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Hamada T, Matsukita S, Goto M, Kitajima S, Batra SK, Irimura T, Sueyoshi K, Sugihara K, Yonezawa S. Mucin expression in pleomorphic adenoma of salivary gland: a potential role for MUC1 as a marker to predict recurrence. J Clin Pathol 2004; 57:813-21. [PMID: 15280401 PMCID: PMC1770389 DOI: 10.1136/jcp.2003.014043] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Pleomorphic adenoma of the salivary gland (PA) is essentially a benign neoplasm. However, patients with recurrent PA are difficult to manage. There are rare reports on useful immunohistochemical markers to detect a high risk of recurrence when the primary lesions are resected. AIMS To find a new marker to predict the recurrence of PA. METHODS Primary lesions of PA were collected from nine patients showing subsequent recurrence and from 40 patients without recurrence during at least 10 years of follow up of the disease. Paraffin wax embedded tumour samples of the two groups were examined for the expression profiles of MUC1 (differentially glycosylated forms), MUC2, MUC4, MUC5AC, and MUC6 using immunohistochemistry. Several clinicopathological factors were also examined. RESULTS In univariate analysis of the factors examined, MUC1/DF3 high expression (more than 30% of the neoplastic cells stained) in the primary lesions was seen more frequently in patients with recurrence (four of nine) than in those without recurrence (three of 40; p = 0.011). Larger tumour size (more than 3.0 cm) of the primary PA was also a significant (p = 0.035) risk factor for the recurrence of PA. In multivariate analysis, only high expression of MUC1/DF3 was found to be a significant independent risk factor for the recurrence of PA (p = 0.021). CONCLUSIONS Expression of MUC1/DF3 in PA is a useful marker to predict its recurrence. Those patients with PA showing positive MUC1/DF3 expression should be followed up carefully.
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Affiliation(s)
- T Hamada
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medicine and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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