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Muniz VRVM, Altemani A, Freitas VS, Pires BC, de Santana DA, Couto LA, Cangussu MCT, Gomez RS, de Souza SCOM, Vargas PA, Cury PR, de Araújo IB, Chaves RRM, Fonseca FP, Dos Santos JN. Chronic Sclerosing Sialadenitis of the Submandibular Gland and its Histopathological Spectrum in the IgG4-Related Disease: a Series of 17 Cases. Head Neck Pathol 2024; 18:42. [PMID: 38735890 PMCID: PMC11089028 DOI: 10.1007/s12105-024-01651-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/30/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE This study aimed to characterize the histopathological immunohistochemical features of chronic sclerosing sialadenitis, emphasizing the IgG4-related disease. METHODS Seventeen cases of chronic sclerosing sialoadenitis were examined for histopathological aspects, (inflammation, fibrosis, glandular parenchyma, and lymphoid follicles) and immunohistochemistry (BCL2, CD3, CD20, CD34, CD163, p63, cyclin D1, mast cell, SMA, S100A4, IgG, and IgG4) which were scored. IgG4-related disease features were investigated. Demographic and clinical data were also collected. RESULTS Males predominated (10:7), with an average lesion size of 3.9 cm. Common histopathological findings included reduced acinar parenchyma, lymphoid follicle formation, and ductular proliferation. CD3-positive T lymphocytes and CD34- and SMA-positive stromal fibroblasts were abundant. Nine cases (53%) showed sialoliths and three cases met the criteria for IgG4-related disease. CONCLUSION CSS of the submandibular gland represents a reactive pattern rather than IgG4-RD as only 3 cases seemed to be related to IgG4-RD. The immunohistochemical profile revealed an abundant population of CD3-positive T lymphocytes, as opposed to regulatory proteins such as cyclin D1, demonstrating that populations of CD34- and SMA-positive stromal fibroblasts contribute to the fibrosis characteristic of CSS. In addition, our results provide a comprehensive insight into the study of CSS and its relationship with IgG4-RD.
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Affiliation(s)
| | - Albina Altemani
- Department of Pathology, School of Medical Sciences, State University of Campinas, Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Valéria Souza Freitas
- Department of Health, School of Dentistry, State University of Feira de Santana (UEFS), Feira de Santana, Feira de Santana, Bahia, Brazil
| | | | - Dandara Andrade de Santana
- Department of Biological Sciences, State University of Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil
| | - Larissa Abbehusen Couto
- Department of Biological Sciences, State University of Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil
| | | | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Pablo Augustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Patrícia Ramos Cury
- Department of Biological Sciences, State University of Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil
| | - Iguaracyra Barreto de Araújo
- Department of Pathology and Forensic Medicine, School of Medicine, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Roberta Rayra Martins Chaves
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Jean Nunes Dos Santos
- Laboratory of Oral and Maxillofacial Pathology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.
- Faculdade de Odontologia - UFBA, Laboratório de Patologia Oral e Maxilofacial, Avenida Araújo Pinho, 62, Canela, Salvador, 40110-150, Bahia, Brazil.
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Mohammad DN, Ibraheem BF, Khudair HH, Mahmood DK. Expression of Syndecan-1 and Cyclin D1 in Salivary Gland Tumors in Relation to Clinicopathological Parameters. Int J Gen Med 2023; 16:823-835. [PMID: 36883123 PMCID: PMC9985872 DOI: 10.2147/ijgm.s401747] [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: 12/29/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Abstract
Background Salivary tumors have various morphological features and might share some histopathological findings. They are considered a problematic area in diagnosis due to complex clinicopathological features and different biological behavior. Objective To identify the pathological behavior of salivary tumors immunohistochemically. Methodology This retrospective study involved thirty formalin-fixed paraffin-embedded blocks of salivary gland tumors. These tumors were stained immunohistochemically with syndecan-1 and cyclin D1. Chi-Square test was used to relate immunoscoring, intracellular localization, intensity, and invasion to different salivary tumors. The correlation of these two markers was done by spearman's rho test. P-value <0.05 was considered statistically significant. Results The mean age of the patients was 48.69 ± 17.7. The parotid gland was the most commonly reported site in benign tumors, and regarding malignant tumors, maxilla was the most prevalent site. Syndecan-1 in benign tumors showed a predominate score 3, most widely detected in pleomorphic adenoma. Malignant salivary tumors showed 89.4% positive expression with a more frequent score 3, most commonly found in adenocystic carcinoma. Cyclin D1 expressed in all benign salivary tumors, with prominent diffuse mixed intracellular localization in pleomorphic adenoma. Malignant tumors revealed an expression of 94.7%. Moderate scoring with mixed intracellular localization was recorded in adenocystic carcinoma, followed by mucoepidermoid carcinoma. There was a significant correlation between the two markers in response to the distribution of immunostaining in different cell compartments. Conclusion Syndecan-1 and cyclin D1 showed a significant combined role in salivary tumor progression. Interestingly notable ductal-myoepithelial cells affect epithelial morphogenesis, and growth of pleomorphic adenoma was observed. Furthermore, basophilic cells of cribriform adenocystic carcinomas might control the aggressiveness and proliferation rate of these tumors.
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Affiliation(s)
- Dena Nadhim Mohammad
- Oral Pathology, Oral Diagnosis Department, College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Ban Falih Ibraheem
- Oral Pathology, Oral Diagnosis Department, College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Hassanain Hafidh Khudair
- General Pathology, Pathology Department, College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Darya Khalid Mahmood
- Oral Pathology, Oral Diagnosis Department, College of Dentistry, University of Sulaimani, Sulaimani, Iraq
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Markkanen A, Aro K, Laury AR, Mäkitie AA, Haglund C, Atula T, Hagström J. Increased MIB-1 expression in salivary gland pleomorphic adenoma that recurs and undergoes malignant transformation. Sci Rep 2022; 12:9029. [PMID: 35637257 PMCID: PMC9151807 DOI: 10.1038/s41598-022-13082-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
The objective of this retrospective study was to explore possible changes in histopathological features and expression of cyclin D1 and MIB-1 in salivary gland pleomorphic adenomas (PAs) that recur or undergo malignant transformation. Knowledge of these characteristics might help to guide the management of these rare tumors. The histopathology and immunohistochemical staining characteristics of such tumors were analyzed in a cohort of 65 patients constituting three different groups of tumors: PA, recurrent pleomorphic adenoma (RPA) and carcinoma ex PA (CxPA). The RPAs were divided into two subgroups: primary PA that were known to recur later (PA-prim) and recurrent tumors appearing after a primary tumor (PA-rec). RPAs and CxPAs were compared with PAs without recurrence, which served as a control group. In our study, CxPA and PA-rec, but not PA-prim, showed increased MIB-1 expression compared with the control group. Neither cyclin D1 expression nor any histopathological features showed any association in statistical analyses. CxPA showed increased mitotic activity, squamous metaplasia, and nuclear atypia. Tumor multifocality was more frequent in PA-rec and CxPA. The different MIB-1 expression in CxPA and PA-rec in comparison to PA-prim suggests that the changes in expression could develop after the primary tumor.
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Integrative analysis of long non-coding RNAs and mRNAs associated with tumorigenesis of salivary gland pleomorphic adenoma. Arch Oral Biol 2021; 133:105303. [PMID: 34775268 DOI: 10.1016/j.archoralbio.2021.105303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 10/23/2021] [Accepted: 10/30/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The current study investigated long non-coding RNA (lncRNA) and mRNA profiles of the human salivary gland pleomorphic adenoma (SGPA). DESIGN Microarray analysis was used to study the expression of lncRNAs and mRNAs and the differentially expressed lncRNAs in human SGPA (all from parotid gland) were identified. The differentially expressed lncRNAs were subjected to qRT-PCR to verify and quantify their expression and a lncRNA-mRNA co-expression network was constructed. The lncRNAs correlated to pleomorphic adenoma gene 1 (PLAG1), a known key transcription factor, were identified and analyzed. RESULTS In the present study, 17,382 lncRNAs and 8132 mRNAs were found to be significantly differentially expressed in SGPA (fold change > 2, P < 0.05). The expression of three lncRNAs (NR_110874, NR_110875 and T087085) was significantly altered in SGPA compared to the corresponding healthy tissues, and it was confirmed using the lncRNA-mRNA co-expression network analysis that several lncRNAs interact with 5 key regulators (PLAG1, CTNNB1, CCND1, IGF2, and TP53). Furthermore, T042819 was significantly upregulated in SGPA, which may upregulate PLAG1 by sponging has-miR195-5p. CONCLUSION These data suggested that the differently expressed lncRNAs may contribute to the tumorigenesis of SGPA, and analyzing the differences in the lncRNA expression profiles may provide novel insights into the pathogenesis of SGPA.
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Bartkowiak E, Piwowarczyk K, Bodnar M, Kosikowski P, Chou J, Woźniak A, Wierzbicka M. Expression of p16 Ink4a protein in pleomorphic adenoma and carcinoma ex pleomorphic adenoma proves diversity of tumour biology and predicts clinical course. J Clin Pathol 2021; 75:605-611. [PMID: 33941588 PMCID: PMC9411887 DOI: 10.1136/jclinpath-2021-207440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
Aims The aim of the study is to correlate p16Ink4a expression with the clinical courses of pleomorphic adenoma (PA), its malignant transformation (CaexPA) and treatment outcomes. Methods Retrospective analysis (1998–2019) of 47 CaexPA, 148 PA and 22 normal salivary gland samples was performed. PAs were divided into two subsets: clinically ‘slow’ tumours characterised by stable size or slow growth; and ‘fast’ tumours with rapid growth rate. Results Positive p16Ink4a expression was found in 68 PA and 23 CaexPA, and borderline expression in 80 and 20, respectively. All 22 (100%) normal salivary gland samples presented with no p16Ink4a expression. Significant difference in p16Ink4a expression was observed between normal tissue, PA and CaexPA (χ2 (4)=172,19; p=0.0001). The PA clinical subgroups were also evaluated separately, revealing additional statistical relations: ‘fast’ PA and CaexPA differed significantly in p16Ink4a expression (χ2 (2)=8.06; p=0.01781) while ‘slow’ PA and CaexPA did not (χ2 (2)=3.09; p=0.2129). 3-year, 5-year and 10-year survival among p16Ink4a positive CaexPA patients was 100%, 90.56% and 60.37%, respectively, and in CaexPA patients with borderline p16Ink4a expression was 90.0%, 73.64% and 22.20%, respectively. Statistically significant difference between expression pattern and survival rate was observed (F Cox test – F (16, 24)=2.31; p=0.03075). Conclusions Our study confirms no p16Ink4a expression in normal tissue, but reveals differences in expression between ‘fast’ and ‘slow’ PA. We suggest that p16Ink4a overexpression is connected to PA proliferation and subsequent malignant transformation to CaexPA. Borderline p16Ink4a staining correlates with worse prognosis of CaexPA.
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Affiliation(s)
- Ewelina Bartkowiak
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Piwowarczyk
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Bodnar
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland.,Department of Clinical Pathomorphology, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Paweł Kosikowski
- Department of Clinical Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jadzia Chou
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Aldona Woźniak
- Department of Clinical Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Wierzbicka
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
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Khanna D, Chaubal T, Bapat R, Abdulla AM, Philip ST, Arora S. Carcinoma ex pleomorphic adenoma: a case report and review of literature. Afr Health Sci 2019; 19:3253-3263. [PMID: 32127904 PMCID: PMC7040348 DOI: 10.4314/ahs.v19i4.50] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Carcinoma ex pleomorphic adenoma (CA-ex-PA) is extremely unusual in minor salivary glands of oral cavity. CAex-PA is a carcinomatous change as a primary or as a recurrence of pleomorphic adenoma. Objective Due to resemblance of clinical symptoms of Ca ex PA and benign pleomorphic adenoma, it is mandatory for surgeons to keep high degree of clinical alertness, considering the peculiarity of this tumor. Case Report 54-year-old male presented with swelling on left side in the pre-auricular region from the middle of zygomatic arch to mastoid process and from tragus of the ear up to angle of mandible. Fine needle aspiration cytology revealed a mixture of benign and malignant components. Total left parotidectomy with left radical neck dissection followed by reconstruction with cervicodeltopectoral flap was performed. Combination of chemotherapy and radiotherapy were given to patient. Histologic examination and pre-operative fine needle aspiration cytology confirmed the diagnosis of Carcinoma ex pleomorphic adenoma (CA-ex-PA). Two-year follow-up of patient showed no recurrence of the lesion. Conclusion Due to the similarity in the clinical symptoms of CA-ex-PA and benign pleomorphic adenoma, it is vital that clinicians maintain a high degree of clinical vigilance, considering the oddity of this malignancy.
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Affiliation(s)
- Deepak Khanna
- Department of Head, neck and oncology, D.Y.Patil University School of medicine, Nerul, Navi Mumbai, Maharashtra state, India, Zip code – 400706
| | - Tanay Chaubal
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia, Zip code – 57000
| | - Ranjeet Bapat
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia, Zip code – 57000
| | - Anshad Mohamed Abdulla
- Department of Pediatric dentistry and Orthodontic Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia, Pincode- 61471
| | - Sunil Thomas Philip
- Department of Pedodontics and Preventive Dentistry, Noorul Islam College of Dental Sciences, Trivandrum, Kerala, India
| | - Suraj Arora
- Department of Restorative Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia, Pincode- 61471
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Sowa P, Goroszkiewicz K, Szydelko J, Chechlinska J, Pluta K, Domka W, Misiolek M, Scierski W. A Review of Selected Factors of Salivary Gland Tumour Formation and Malignant Transformation. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2897827. [PMID: 30155477 PMCID: PMC6092996 DOI: 10.1155/2018/2897827] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/12/2018] [Indexed: 12/13/2022]
Abstract
Salivary gland tumours represent about 6% of head and neck neoplasms and about 0.5% of all malignancies in humans. Tumour growth and malignant transformation are complex processes involving various actions of molecules. Furthermore, some malignant salivary gland tumours are deemed to be caused by dedifferentiation or malignant transformation of benign tumours. The mechanisms of this transformation depend on a variety of different elements, such as cell cycle regulators, oncogenes, proteins, angiogenesis factors, and adipocytokines. The authors used PubMed, Medline, and Google websites to find and review the most significant papers related to malignant transformation in benign salivary gland tumours.
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Affiliation(s)
- Pawel Sowa
- Department of Otorhinolaryngology and Oncological Laryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Karolina Goroszkiewicz
- Department of Otorhinolaryngology and Oncological Laryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Joanna Szydelko
- Department of Otorhinolaryngology and Oncological Laryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Joanna Chechlinska
- Department of Otorhinolaryngology and Oncological Laryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Pluta
- Department of Otorhinolaryngology and Oncological Laryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Wojciech Domka
- Department of Otorhinolaryngology, Faculty of Medicine, University of Rzeszow, Poland
| | - Maciej Misiolek
- Department of Otorhinolaryngology and Oncological Laryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Wojciech Scierski
- Department of Otorhinolaryngology and Oncological Laryngology in Zabrze, Medical University of Silesia, Katowice, Poland
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Tenório JDR, da Silva LP, Xavier MGDA, Santana T, do Nascimento GJF, Sobral APV. Differential expression of cyclooxygenase-2 and cyclin D1 in salivary gland tumors. Eur Arch Otorhinolaryngol 2018; 275:2341-2347. [PMID: 30003391 DOI: 10.1007/s00405-018-5058-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/02/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Salivary gland tumors are complex and have a great histomorphological diversity; more than 30 histological subtypes are currently described and the study of proteins that help understand and differentiate these tumors is essential. We aimed to analyze the immunoexpression of cyclooxygenase-2 (COX-2) and cyclin D1 proteins in pleomorphic adenomas (PA), mucoepidermoid carcinomas (MEC) and adenoid cystic carcinomas (AdCC) of salivary glands. METHODS A total of 38 PA, 12 AdCC and 12 MEC underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were analyzed semi-quantitatively. For statistical analysis, a significance level was set at p ≤ 0.05. RESULTS Overall, these tumors were more prevalent in women (n = 37). The mean age of these patients was 58-year-old and the parotid gland was the most affected anatomic site (n = 33). All cases of AdCC and MEC showed immunopositivity to cyclin D1; however, 39.5% of the PAs were negative (p < 0.001). Regarding COX-2 immunoexpression, we observed that all cases of CME were positive, whereas 60.5% of the PA and 75% of the CAC analyzed were completely negative (p = 0.042). CONCLUSIONS The overexpression of COX-2, observed only in MEC, emphasizes that salivary gland tumors have different profiles. Cyclin D1 is more immunoexpressed in malignant tumors. Together, these immunohistochemical findings may be useful in differentiating the studied tumors.
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Affiliation(s)
- Jefferson da Rocha Tenório
- Department of Oral Pathology and Special Care Patients, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, Zip code: 05508-900, Brazil.
| | - Leorik Pereira da Silva
- Oral Pathology, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte-UFRN, Natal, Rio Grande Do Norte, Brazil
| | | | - Thalita Santana
- Department of Oral Pathology and Special Care Patients, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, Zip code: 05508-900, Brazil
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Andreasen S, Heegaard S, Grauslund M, Homøe P. The interleukin-6/Janus kinase/STAT3 pathway in pleomorphic adenoma and carcinoma ex pleomorphic adenoma of the lacrimal gland. Acta Ophthalmol 2016; 94:798-804. [PMID: 27286739 DOI: 10.1111/aos.13122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 04/15/2016] [Indexed: 01/05/2023]
Abstract
PURPOSE Pleomorphic adenoma (PA) is the most common tumour of the lacrimal gland, but very little is known about its biology. It has a tendency to recur and an ability to transform into the high-grade malignancy carcinoma ex pleomorphic adenoma (ca-ex-PA), which is also largely unexplored. In this study, we examine the expression of the interleukin-6/Janus kinase/STAT3 (IL-6/JAK/STAT3) pathway components in PA and ca-ex-PA. METHODS Sixteen PAs and two ca-ex-PAs were examined with immunohistochemistry. Seven PAs were subjected to microdissection and subsequent qPCR. RESULTS The IL-6/JAK/STAT3 pathway was overexpressed in PA compared to normal lacrimal gland. Overexpression of phosphorylated JAK1 (p-JAK1) and cyclin D1 was significantly overexpressed in ductal cells compared with myoepithelial cells in PA. A shift from p-JAK1 to p-JAK2 and p-Tyk2 overexpression was seen between PA and ca-ex-PA, combined with a high p-STAT3 expression in the latter. CONCLUSION The IL-6/JAK/STAT3 pathway is overexpressed in PA, and this overexpression was even more pronounced in ca-ex-PA, with a shift in the JAKs mediating STAT3 phosphorylation. Future studies are needed to clarify whether PA and ca-ex-PA could be treated with targeted therapy directed against components of the IL-6/JAK/STAT3 pathway.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology Head & Neck Surgery and Audiology; Rigshospitalet; Copenhagen Denmark
- Department of Otorhinolaryngology and Maxillofacial Surgery; Køge University Hospital; Køge Denmark
- University of Copenhagen; Copenhagen Denmark
| | - Steffen Heegaard
- Department of Pathology; Rigshospitalet; Copenhagen Denmark
- Department of Ophthalmology; Righospitalet-Glostrup; Copenhagen Denmark
| | | | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery; Køge University Hospital; Køge Denmark
- University of Copenhagen; Copenhagen Denmark
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Abstract
Oral squamous cell carcinoma is the most common neoplasia of the mouth. Downregulation of p16(INK4a) (a cyclin-dependent kinase inhibitor) has been reported for mouth cancer and it is believed that its inactivation is an early event in oral carcinogenesis. The goal of this article is to quantitatively report expression of p16(INK4a) and the state of methylation in oral squamous cell carcinoma, and evaluate its relationship with the clinical and prognostic factors, in addition to setting out a multivariate model that predicts survival. The mean expression of p16(INK4a) was 7.70 (SD=14.07) (F=0.894; P=0.449). According to the semiquantitative analysis, there were statistically significant differences, where 19 cases were negative (<2 %), 11 at initial stages, and 8 at advanced stages (χ(2)=6.016; P<0.05). The methylation of p16(INK4a) was not associated with any of the clinical or pathologic variables. Kaplan-Meier curve showed a better survival for patients in initial stages (40.72 mo) compared to those in advanced stages (28.6 mo) (P<0.01). Survival was also reduced in a statistically significant manner in patients with any degree of dysplasia in the adjacent margin (P<0.05). During univariate Cox regression analysis, it was observed that individuals with relapse had a higher risk (almost 9 times higher) [P<0.001; hazard ratio=8.91; 95% confidence interval (CI), 4.18-19.02]. During the Cox multivariate analysis for each unit of decrease in p16(INK4a), the risk increased by 1.06) (P<0.05; hazard ratio=0.94; 95% CI, 0.89-1.00). p16(INK4a) expression is reduced with advancing tumor stage and its gene silencing is associated with an increased risk of death.
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ClC-3 Chloride Channel Proteins Regulate the Cell Cycle by Up-regulating cyclin D1-CDK4/6 through Suppressing p21/p27 Expression in Nasopharyngeal Carcinoma Cells. Sci Rep 2016; 6:30276. [PMID: 27451945 PMCID: PMC4959003 DOI: 10.1038/srep30276] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 06/03/2016] [Indexed: 12/24/2022] Open
Abstract
It was shown in this study that knockdown of ClC-3 expression by ClC-3 siRNA prevented the activation of hypotonicity-induced chloride currents, and arrested cells at the G0/G1 phase in nasopharyngeal carcinoma CNE-2Z cells. Reconstitution of ClC-3 expression with ClC-3 expression plasmids could rescue the cells from the cell cycle arrest caused by ClC-3 siRNA treatments. Transfection of cells with ClC-3 siRNA decreased the expression of cyclin D1, cyclin dependent kinase 4 and 6, and increased the expression of cyclin dependent kinase inhibitors (CDKIs), p21 and p27. Pretreatments of cells with p21 and p27 siRNAs depleted the inhibitory effects of ClC-3 siRNA on the expression of CDK4 and CDK6, but not on that of cyclin D1, indicating the requirement of p21 and p27 for the inhibitory effects of ClC-3 siRNA on CDK4 and CDK6 expression. ClC-3 siRNA inhibited cells to progress from the G1 phase to the S phase, but pretreatments of cells with p21 and p27 siRNAs abolished the inhibitory effects of ClC-3 siRNA on the cell cycle progress. Our data suggest that ClC-3 may regulate cell cycle transition between G0/G1 and S phases by up-regulation of the expression of CDK4 and CDK6 through suppression of p21 and p27 expression.
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de Souza AA, Altemani A, Passador-Santos F, Turssi CP, de Araujo NS, de Araújo VC, Soares AB. Dysregulation of the Rb pathway in recurrent pleomorphic adenoma of the salivary glands. Virchows Arch 2015; 467:295-301. [PMID: 26155914 DOI: 10.1007/s00428-015-1804-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/05/2015] [Accepted: 06/24/2015] [Indexed: 11/28/2022]
Abstract
Pleomorphic adenoma (PA) is the most common salivary gland neoplasm, and while mostly benign, recurrences (RPA) and malignant transformation to carcinoma ex-PA (CXPA) do occur. Cell cycle proteins important in its tumorigenesis have been studied as markers for PA with a high risk of RPA or CXPA. The aim of the present study was to investigate cell cycle markers p-16, cyclin D1, CDK4, E2F, and retinoblastoma (Rb) in this context. Expression of p16, cyclin D1, E2F, CDK4, and Rb was studied by immunohistochemistry in 24 cases of PA, 21 of RPA, and 2 of CXPA. The presence of HPV was assessed by in situ hybridization. Immunostaining for p16 and cyclin D1 was negative or weakly positive in most cases of PA while strongly positive in the majority of RPA and both CXPA cases. Staining for Rb and CDK4 was either negative or weakly positive in PA, RPA, and CXPA. Expression of E2F was stronger in RPA and CXPA than in PA. Nuclear reactivity for HPV was not observed in any case. In conclusion, the strong staining for p16, cyclinD1, and E2F in RPA and CXPA, while weak or negative in PA, suggests that these proteins might be involved in recurrence and malignant transformation of PA.
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Affiliation(s)
- Ana Amélia de Souza
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Rua José Rocha Junqueira13 Ponte Preta, Campinas, SP, 13045-755, Brazil
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13
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Andreasen S, Therkildsen MH, Grauslund M, Friis-Hansen L, Wessel I, Homøe P. Activation of the interleukin-6/Janus kinase/STAT3 pathway in pleomorphic adenoma of the parotid gland. APMIS 2015; 123:706-15. [PMID: 26061266 DOI: 10.1111/apm.12407] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 04/20/2015] [Indexed: 12/15/2022]
Abstract
The interleukin-6 (IL-6)/Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) pathway is of crucial importance in promoting tumorigenesis in several malignant tumors but may also be active in benign tumors, e.g., of pleomorphic adenoma (PA). In this study we characterize the expression of the pathway components with immunohistochemistry and selected mRNAs and microRNAs (miRNAs) regulated by this pathway in isolated duct- and myoepithelial cells in PA. 46 PAs were immunostained and 10 of these were used for in situ hybridization (ISH). Six frozen specimens were analyzed using reverse transcription-polymerase chain reaction (RT-PCR). Using immunohistochemistry, IL-6, JAK1, JAK2 and STAT3 were detected significantly more frequently in PA cells than in cells from normal salivary gland tissue. Using RT-PCR cyclin D1, fibroblast growth factor 2, and p21 were found to be overexpressed while matrix metallopeptidase 9 was detected at low levels in PA compared to normal salivary gland. ISH showed significant overexpression of miR-181b in PA, while miR-21 was undetectable in PA and normal tissue. Overexpression of the pathway components and its mRNA and miRNA products provide important clues regarding the growth of PAs. Our findings brings us one step closer to targeted treatment of this tumor entity, although in vitro studies are warranted to confirm this.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.,Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, Køge, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Irene Wessel
- Department of Otorhinolaryngology Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.,Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, Køge, Denmark.,University of Copenhagen, Copenhagen, Denmark
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14
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High-Grade Transformation (“Dedifferentiation”)—Malignant Progression of Salivary Gland Neoplasms, Including Carcinoma ex Pleomorphic Adenoma. AJSP-REVIEWS AND REPORTS 2015. [DOI: 10.1097/pcr.0000000000000076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Lill C, Schneider S, Seemann R, Kadletz L, Aumayr K, Ghanim B, Thurnher D. Correlation of β-catenin, but not PIN1 and cyclin D1, overexpression with disease-free and overall survival in patients with cancer of the parotid gland. Head Neck 2014; 37:30-6. [PMID: 24500803 DOI: 10.1002/hed.23546] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 08/26/2013] [Accepted: 10/31/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Malignant tumors of the salivary glands comprise about 3% to 5% of all head and neck carcinomas. The purpose of our study was to find possible predictive and/or prognostic markers for parotid cancer. METHODS A total of 46 tissue samples of carcinomas of the parotid gland were immunohistochemically stained for ß-catenin, cyclin D1, and PIN1. The factors were analyzed regarding their prognostic value for disease-free and overall survival. RESULTS An overexpression of the cytoplasmatic ß-catenin was linked to a statistically significant worse outcome regarding disease-free (p = .0296) and overall survival (p = .0416). The 5-year overall survival was 83.9% in patients without and 0% in patients presenting with overexpression of cytoplasmatic ß-catenin. Additionally, Union Internationale Contre le Cancer (UICC) stage correlated with overall survival (p = .0306) and disease-free survival (DFS; p = .0473). CONCLUSION Multivariate analysis showed that overexpression of cytoplasmatic ß-catenin and the UICC stage are 2 independent prognostic markers for survival in patients with parotid cancer.
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Affiliation(s)
- Claudia Lill
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
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16
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Tarakji B, Altamimi MA, Baroudi K, Nassain MZ, Alenzi FQ. Immunohistochemical expression of p16 in Carcinoma Ex-pleomorphic Adenoma (undifferentiated and Adenocarcinoma Types). J Clin Diagn Res 2013; 7:3054-6. [PMID: 24551726 DOI: 10.7860/jcdr/2013/7380.3851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/27/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study was aimed at characterizing alterations in the immunohistochemical expression of p16 in carcinoma ex-pleomorphic adenomas. STUDY DESIGN A selected series of 27 cases of carcinoma ex-pleomorphic adenomas were examined. RESULTS The results showed that p16 expression in non tumour duct cells was strongly positive nuclear staining in 23 (85%) cases out of 27 cases, that 3 (11.1%) had moderate staining, and that 1 (3.7%) had weak staining. p16 expression in carcinoma ex-pleomorphic adenomas was indicated as a negative nuclear staining in 22 (81.4%) cases out of 27cases, and 5 (18.5%) cases expressed moderate staining. CONCLUSION This study suggests that alteration of p16 expression is detected in carcinoma ex-pleomorphic adenomas. p16 has a role in development of carcinoma ex-pleomorphic adenomas.
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Affiliation(s)
- Bassel Tarakji
- Faculty, Head of Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing , Kingdom of Saudi Arabia, Riyadh
| | - Mohammed Alsakran Altamimi
- Faculty, Department of Restorative Dental Sciences, Alfarabi College of Dentistry and Nursing , Kingdom of Saudi Arabia, Riyadh
| | - Kusai Baroudi
- Faculty, Department of Restorative Dental Sciences, Alfarabi College of Dentistry and Nursing , Kingdom of Saudi Arabia, Riyadh
| | - Mohammad Z Nassain
- Faculty, Department of Restorative Dental Sciences, Alfarabi College of Dentistry and Nursing , Kingdom of Saudi Arabia, Riyadh
| | - Faris Q Alenzi
- Faculty, College of Applied Medical Sciences, Prince Salman University , Al-Kharj, Saudi Arabia
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17
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Differential expression of p16(INK4A) and cyclin D1 in benign and malignant salivary gland tumors: a study of 44 Cases. Head Neck Pathol 2013; 7:224-31. [PMID: 23315417 PMCID: PMC3738749 DOI: 10.1007/s12105-012-0417-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/27/2012] [Indexed: 01/15/2023]
Abstract
Salivary gland tumors (SGT) are a heterogeneous group of lesions. There is conflicting data concerning the molecular events involving the tumour suppressor retinoblastoma protein (pRb) pathway in these tumors. Few studies examined the alterations in components of the Rb pathway by immunohistochemical (IHC) methods in benign and malignant SGTs. Furthermore, recent evidence implicates human papillomavirus (HPV) in mucoepidermoid carcinoma (MEC) carcinogenesis. The purpose of our study is to examine p16(INK4A) and cyclin D1 expression in a variety of benign and malignant salivary gland tumors, and to investigate p16(INK4A) expression as a surrogate marker for HPV infection in MEC. Our series includes 30 malignant tumors [14 MEC, 6 acinic cell carcinomas (ACC), 5 polymorphous low grade adenocarcinomas (PLGA), 5 (AdCC)] and 14 benign tumors (4 benign cysts, 5 Warthin tumors and 5 pleomorphic adenomas (PA). All cases were tested by IHC for p16(INK4A) and cyclin D1. Testing for HPV wide spectrum (HPV-WS) was performed by in situ hybridization in all MEC cases. Staining intensity was recorded semi quantitatively (on a scale from 0 to 4+). Fisher's exact test and Pearson X2 test with a p < 0.05 were used. Cyclin D1 and p16(INK4A) are expressed similarly in malignant and benign tumors (p = 0.146 and p = 0.543, respectively). None of the MEC cases showed nuclear reactivity for HPV-WS. Statistical analysis showed positive correlation between cyclin D1 and p16(INK4A) expression. Our findings suggest that p16(INK4A) overexpression is likely secondary to cyclin D1 gene upregulation or amplification. Further molecular studies are warranted.
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18
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Hu YH, Zhang CY, Tian Z, Wang LZ, Li J. Aberrant protein expression and promoter methylation of p16 gene are correlated with malignant transformation of salivary pleomorphic adenoma. Arch Pathol Lab Med 2011; 135:882-9. [PMID: 21732778 DOI: 10.5858/2010-0181-oari.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT The significance of promoter methylation of the p16 gene and intracellular localization of p16 protein in the carcinogenesis of salivary carcinoma ex pleomorphic adenoma (Ca-ex-PA) is not clear. The correlation of the promoter methylation of the p16 gene and the expression and localization of p16 protein in Ca-ex-PA need to be further clarified. OBJECTIVE To investigate the p16 protein expression and promoter methylation of p16 gene in Ca-ex-PA and their roles in the malignant transformation of pleomorphic adenoma to Ca-ex-PA. DESIGN The p16 protein expression and promoter methylation of the p16 gene were determined in both benign and malignant components of 50 primary salivary Ca-ex-PA tissues by immunohistochemistry and methylation-specific polymerase chain reaction. Expression of p16 protein and promoter methylation of the p16 gene between the benign and the malignant components was compared statistically. RESULTS The tumor cells in the malignant components showed significantly higher p16 protein expression in the cytoplasm and lower expression in the nuclei than those in the benign components. Promoter methylation frequency of the p16 gene in the malignant components (36%) was significantly higher than that in the benign components (16%). There were no correlations between p16 protein expression and promoter methylation of the p16 gene in either benign or malignant components. CONCLUSIONS Overexpression of p16 protein in the cytoplasm and decreased expression of p16 protein in the nucleus may play important roles in the evolution of pleomorphic adenoma to Ca-ex-PA. Promoter methylation of the p16 gene may be correlated with the malignant transformation of pleomorphic adenoma.
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Affiliation(s)
- Yu-Hua Hu
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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19
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Liu W, Zhu E, Wang R, Wang L, Gao L, Yang X, Liu T. Cyclin D1 gene polymorphism, A870G, is associated with an increased risk of salivary gland tumors in the Chinese population. Cancer Epidemiol 2011; 35:e12-7. [DOI: 10.1016/j.canep.2010.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 11/11/2010] [Accepted: 11/16/2010] [Indexed: 01/10/2023]
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20
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Antony J, Gopalan V, Smith RA, Lam AKY. Carcinoma ex pleomorphic adenoma: a comprehensive review of clinical, pathological and molecular data. Head Neck Pathol 2011; 6:1-9. [PMID: 21744105 PMCID: PMC3311945 DOI: 10.1007/s12105-011-0281-z] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 06/27/2011] [Indexed: 01/11/2023]
Abstract
Carcinoma ex pleomorphic adenoma (Ca ex PA) is a carcinoma arising from a primary or recurrent benign pleomorphic adenoma. It often poses a diagnostic challenge to clinicians and pathologists. This study intends to review the literature and highlight the current clinical and molecular perspectives about this entity. The most common clinical presentation of CA ex PA is of a firm mass in the parotid gland. The proportion of adenoma and carcinoma components determines the macroscopic features of this neoplasm. The entity is difficult to diagnose pre-operatively. Pathologic assessment is the gold standard for making the diagnosis. Treatment for Ca ex PA often involves an ablative surgical procedure which may be followed by radiotherapy. Overall, patients with Ca ex PA have a poor prognosis. Accurate diagnosis and aggressive surgical management of patients presenting with Ca ex PA can increase their survival rates. Molecular studies have revealed that the development of Ca ex PA follows a multi-step model of carcinogenesis, with the progressive loss of heterozygosity at chromosomal arms 8q, then 12q and finally 17p. There are specific candidate genes in these regions that are associated with particular stages in the progression of Ca ex PA. In addition, many genes which regulate tumour suppression, cell cycle control, growth factors and cell-cell adhesion play a role in the development and progression of Ca ex PA. It is hopeful that these molecular data can give clues for the diagnosis and management of the disease.
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Affiliation(s)
- Joyce Antony
- Department of Pathology, Griffith Medical School, Griffith Health Institute, Gold Coast Campus, Gold Coast, QLD 4222 Australia
| | - Vinod Gopalan
- Department of Pathology, Griffith Medical School, Griffith Health Institute, Gold Coast Campus, Gold Coast, QLD 4222 Australia
| | - Robert A. Smith
- Department of Pathology, Griffith Medical School, Griffith Health Institute, Gold Coast Campus, Gold Coast, QLD 4222 Australia
| | - Alfred K. Y. Lam
- Department of Pathology, Griffith Medical School, Griffith Health Institute, Gold Coast Campus, Gold Coast, QLD 4222 Australia
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21
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p16(INK4a)/CDKN2 expression and its relationship with oral squamous cell carcinoma is our current knowledge enough? Cancer Lett 2011; 306:134-41. [PMID: 21411222 DOI: 10.1016/j.canlet.2011.02.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 02/21/2011] [Accepted: 02/23/2011] [Indexed: 11/23/2022]
Abstract
Oral squamous cell carcinomas (OSCC) are the most common malignancy of the oral cavity and their multistep development requires the accumulation of multiple genetic and epigenetic alterations. Inactivation of p16(INK4a), encoded by the CDKN2 gene has been widely associated with this type of tumors. The purpose of this review is to elucidate the relationship between p16(INK4a) expression and the different clinical and pathological aspects of OSCC, analyze the variation in results between studies, detailing the described genetic/epigenetic alterations that result in gene silencing and the relationship between p16(INK4a) and HPV infection.
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22
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Quantitative promoter methylation differentiates carcinoma ex pleomorphic adenoma from pleomorphic salivary adenoma. Br J Cancer 2010; 103:1846-51. [PMID: 21063414 PMCID: PMC3008600 DOI: 10.1038/sj.bjc.6605953] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: Potential epigenetic biomarkers for malignant transformation to carcinoma ex pleomorphic adenoma (Ca ex PSA) have been sought previously with and without specific comparison with the benign variant, pleomorphic salivary adenoma (PSA). Previous analysis has been limited by a non-quantitative approach. We sought to demonstrate quantitative promoter methylation across a panel of tumour suppressor genes (TSGs) in both Ca ex PSA and PSA. Methods: Quantitative methylation-specific real-time polymerase chain reaction (qMSP) analysis of p16INK4A, CYGB, RASSF1, RARβ, human telomerase reverse transcriptase (hTERT), Wilms’ tumour 1 (WT1) and TMEFF2 gene promoters was undertaken on bisulphite-converted DNA, previously extracted from archival fixed tissue specimens of 31 Ca ex PSA and an unrelated cohort of 28 PSA. All target regions examined had formerly been shown to be hypermethylated in salivary and/or mucosal head and neck malignancies. Results: The qMSP demonstrated abnormal methylation of at least one target in 20 out of 31 (64.5%) Ca ex PSA and 2 out of 28 (7.1%) PSA samples (P<0.001). RASSF1 was the single gene promoter for which methylation is shown to be a statistically significant predictor of malignant disease (P<0.001) with a sensitivity of 51.6% and a specificity of 92.9%. RARβ, TMEFF2 and CYGB displayed no apparent methylation, while a combinatory epigenotype based on p16, hTERT, RASSF1 and WT1 was associated with a significantly higher chance of detecting malignancy in any positive sample (odds ratio: 24, 95% CI: 4.7–125, P<0.001). Conclusions: We demonstrate the successful application of qMSP to a large series of historical Ca ex PSA samples and report on a panel of TSGs with significant differences in their methylation profiles between benign and malignant variants of pleomorphic salivary adenoma. qMSP analysis could be developed as a useful clinical tool to differentiate between Ca ex PSA and its benign precursor.
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23
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Ettl T, Schwarz S, Kleinsasser N, Hartmann A, Reichert TE, Driemel O. Overexpression of EGFR and absence of C-KIT expression correlate with poor prognosis in salivary gland carcinomas. Histopathology 2009; 53:567-77. [PMID: 18983466 DOI: 10.1111/j.1365-2559.2008.03159.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the prognostic impact of expression of receptor tyrosine kinases epidermal growth factor receptor (EGFR), HER2, and C-KIT in relation to established clinicopathological parameters in salivary gland carcinomas. METHODS AND RESULTS Immunohistochemistry for EGFR, HER2, C-KIT and the proliferation marker Ki67 was performed in 101 cases of salivary gland carcinoma and related to long-term clinical follow-up. Immunopositivity of C-KIT was common in adenoid cystic carcinoma (92%). Lack of C-KIT expression occurred in salivary duct carcinoma (P < 0.001) and was associated with high-grade tumours (P = 0.002), positive lymph nodes (P = 0.002) and high expression of Ki67 (P = 0.001). HER2 was typically expressed in salivary duct carcinomas (83%), but was not associated with any other parameter. EGFR overexpression occurred independently of histological type and clinical parameters. On univariate survival analysis, overexpression of EGFR (P = 0.011) and lack of C-KIT (P = 0.014) were associated with worse prognosis, whereas HER2 was of no prognostic significance. On multivariate analysis, the strongest negative predictor of survival was high proliferative activity measured by Ki67 (P = 0.002), followed by presence of residual tumour (P = 0.006), overexpression of EGFR (P = 0.026) and advanced tumour stage (P = 0.041). CONCLUSIONS The expression of receptor tyrosine kinases confers additional prognostic impact on disease-specific survival. EGFR overexpression is an independent negative prognostic factor.
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Affiliation(s)
- T Ettl
- Department of Oral and Maxillofacial Surgery, University of Regensburg, Regensburg, Germany
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24
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Abstract
Myoepithelioma, mixed tumor and parachordoma are uncommon soft tissue tumors thought to represent morphological variants of a single tumor type. The genetic basis of these neoplasms is poorly understood. However, they morphologically resemble mixed tumor of the salivary glands (also known as pleomorphic adenoma), a tumor characterized by deregulated expression of PLAG1 or HMGA2. To evaluate a possible genetic relationship between these soft tissue and salivary gland tumors, PLAG1 expression levels and the genomic status of PLAG1 and HMGA2 were investigated in five soft tissue myoepitheliomas and one pleomorphic adenoma. In addition, all tumors were cytogenetically investigated and whole genome DNA copy number imbalances were studied in five of them. The genetic profiles were heterogeneous and the only aberration common to all soft tissue myoepitheliomas was a minimally deleted region of 3.55 Mb in chromosome band 19p13. Recurrent deletion of CDKN2A suggests that inactivation of this tumor suppressor gene is pathogenetically important in a subset. Furthermore, PLAG1 rearrangement was found in a soft tissue tumor from a patient previously treated for a salivary pleomorphic adenoma, indicating either metastasis of the salivary gland lesion or that some soft tissue tumors develop through the same mechanisms as their salivary gland counterparts.
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