Analysis of clinicopathological characteristics, MYB rearrangement and prognostic factors in salivary adenoid cystic carcinoma

Abstract

Recent studies have indicated that a recurrent t(6;9)(q22-23;p23-24) chromosomal translocation in salivary adenoid cystic carcinoma (ACC) results in a MYB proto-oncogene transcription factor-nuclear factor I/B (MYB-NFIB) gene fusion, which has not previously been detected in any non-ACC carcinomas of the head and neck. In the present study, data on clinical factors affecting the survival rate of patients with salivary ACC from a single institution was retrospectively analyzed, and the frequency of MYB gene rearrangement determined. A total of 97 patient cases were analyzed, and young adults presenting with ACC (<40 years old) accounted for 19.6% of all patients (n=19). A total of 70.1% (n=68) displayed neurological symptoms, including pain, paraesthesia, tongue deviation, and facial paralysis. A marked majority of the analyzed tumors (85.6%) displayed evidence of MYB rearrangement. MYB rearrangement was significantly higher in patients with late Tumor-Node-Metastasis (TNM) stage cancer compared with that in patients with early TNM stage (P=0.033), as detected by a dual color MYB break-apart fluorescence in situ hybridization probe. Kaplan-Meier analysis revealed significant differences in patient overall survival (OS) time with regard to age, gender, TNM stage, neurological symptoms, margin status and MYB rearrangement. Specifically, young age was significantly associated with a shorter OS time. In summary, the present study suggested that young patients with salivary ACC presented with a worse prognosis, in contrast to the majority of patients with salivary ACC. Moreover, MYB alterations exhibited a high positive rate in salivary ACC, and therefore, the absence of MYB rearrangements may be associated with a better prognosis.

Pathological evaluation of tumor grade for salivary adenoid cystic carcinoma: A proposal of an objective grading system

“…One of the controversies regarding management of AdCC patients is whether the grading of AdCC cases has clinical significance 8 . In some studies, grading AdCC cases was useful as a prognostic factor 14,19‐21 and in other studies, the usefulness was not evident 8,22‐24 . In addition, it is not unusual that the AdCC grade has not been incorporated as a factor in the prognostic analysis 25‐29 .…”

“…8 In some studies, grading AdCC cases was useful as a prognostic factor 14,[19][20][21] and in other studies, the usefulness was not evident. 8,[22][23][24] In addition, it is not unusual that the AdCC grade has not been incorporated as a factor in the prognostic analysis. [25][26][27][28][29] This discrepancy is difficult to account for but some explanations can be offered.…”

Pulmonary adenoid cystic carcinoma: molecular characteristics and literature review

“…Xu et al [ 61 ] collected 50 ACC tissues and 41 normal glandular tissues, respectively tested MYB mRNA expression, compared with normal glandular tissue, MYB expression in ACC tissues increased significantly, and MYB was negatively correlated with CDH1 (the gene that encodes cadherin‑1) and positively correlated with VIM (the gene that encodes vimentin), suggesting that MYB induce epithelial-mesenchymal transformation and was related to ACC metastasis, in addition, the researchers injected MYB overexpression cells and normal cells into 7 and 6 mice through veins, respectively, and sacrificed mice 8 weeks later to obtain their lung tissue and the results also prove that MYB promotes lung metastasis of ACC. Similarly, it has been reported that solid histological type and MYB-NFIB balanced translocation mutation are associated with poor prognosis in PACC patients [ 15 , 62 ].…”

Genetic Profiling in Heterogeneous High-Grade Adenoid Cystic Carcinoma Identifies NOTCH1 Inhibition as a Therapeutic Strategy

“…The orange uorochrome directly-labeled probe hybridizes distally, and the green uorochrome directly-labeled probe hybridizes proximal to the MYB breakpoint cluster region. Analysis was conducted as previously described 43 . In an interphase nucleus lacking a translocation involving the 6q23.…”