Treatment and survival outcomes based on histologic grading in patients with head and neck mucoepidermoid carcinoma

Nance, Melonie A.; Seethala, Raja R.; Wang, Yun; Chiosea, Simion I.; Myers, Eugene N.; Johnson, Jonas T.; Lai, Stephen Y.

doi:10.1002/cncr.23825

Cited by 143 publications

(173 citation statements)

References 34 publications

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“…20 Perineural invasion (p=0.746) was seen in 7(35%) cases of AdCC in the current study which is in concurrence with the results of other studies 10 Table- dictates the treatment protocol for the patients of MEC. 6,11,14 The study conducted by Nance 19 Lymph node metastasis were found to be significantly associated with the grade of tumour (p=0.01) being negative in all grade I tumours and positive in 4(44.5%) and 5(55.5%) cases of intermediate and high grade MEC respectively. These results are in accordance to the study conducted by Chen 20 for the fact that highest number of nodal metastasis were seen in high grade tumours (56.8%).…”

Section: Discussionmentioning

confidence: 96%

SALIVARY GLANDS; CLINICAL & HISTOPATHOLOGICAL SPECTRUM OF ADENOID CYSTIC CARCINOMA & MUCOEPIDERMOID CARCINOMAS REPORTED AT TERTIARY CARE HOSPITALS IN LAHORE

Hussain

Naseem

Siraj³

et al. 2017

TPMJ

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Section: Discussionmentioning

confidence: 96%

SALIVARY GLANDS; CLINICAL & HISTOPATHOLOGICAL SPECTRUM OF ADENOID CYSTIC CARCINOMA & MUCOEPIDERMOID CARCINOMAS REPORTED AT TERTIARY CARE HOSPITALS IN LAHORE

Hussain

Naseem

Siraj³

et al. 2017

TPMJ

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“…[4][5][6][7] Nevertheless, all tumors with histologic appearances defined as mucoepidermoid carcinoma are considered malignant. 8 Although efforts have been made to identify clinically useful biomarkers for grading and prognostication [9][10][11][12] there is yet no unifying concept on how to classify mucoepidermoid carcinomas.…”

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confidence: 99%

Genomic profiles and CRTC1–MAML2 fusion distinguish different subtypes of mucoepidermoid carcinoma

et al. 2013

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Mucoepidermoid carcinoma is the most common salivary gland malignancy, and includes a spectrum of lesions ranging from non-aggressive low-grade tumors to aggressive high-grade tumors. To further characterize this heterogeneous group of tumors we have performed a comprehensive analysis of copy number alterations and CRTC1-MAML2 fusion status in a series of 28 mucoepidermoid carcinomas. The CRTC1-MAML2 fusion was detected by RT-PCR or fluorescence in situ hybridization in 18 of 28 mucoepidermoid carcinomas (64%). All 15 low-grade tumors were fusion-positive whereas only 3 of 13 high-grade tumors were fusion-positive. Highresolution array-based comparative genomic hybridization revealed that fusion-positive tumors had significantly fewer copy number alterations/tumor compared with fusion-negative tumors (1.5 vs 9.5; P ¼ 0.002). Twelve of 18 fusion-positive tumors had normal genomic profiles whereas only 1 out of 10 fusionnegative tumors lacked copy number alterations. The profiles of fusion-positive and fusion-negative tumors were very similar to those of low-and high-grade tumors. Thus, low-grade mucoepidermoid carcinomas had significantly fewer copy number alterations/tumor compared with high-grade mucoepidermoid carcinomas (0.7 vs 8.6; Po0.0001). The most frequent copy number alterations detected were losses of 18q12.2-qter (including the tumor suppressor genes DCC, SMAD4, and GALR1), 9p21.3 (including the tumor suppressor genes CDKN2A/B), 6q22.1-q23.1, and 8pter-p12.1, and gains of 8q24.3 (including the oncogene MAFA), 11q12.3-q13.2, 3q26.1-q28, 19p13.2-p13.11, and 8q11.1-q12.2 (including the oncogenes LYN, MOS, and PLAG1). On the basis of these results we propose that mucoepidermoid carcinoma may be subdivided in (i) low-grade, fusion-positive mucoepidermoid carcinomas with no or few genomic imbalances and favorable prognosis, (ii) high-grade, fusion-positive mucoepidermoid carcinomas with multiple genomic imbalances and unfavorable prognosis, and (iii) a heterogeneous group of high-grade, fusion-negative adenocarcinomas with multiple genomic imbalances and unfavorable outcome. Taken together, our studies indicate that molecular genetic analysis can be a useful adjunct to histologic scoring of mucoepidermoid carcinoma and may lead to development of new clinical guidelines for management of these patients.

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“…All our cases of low/intermediate grade MEC had a pattern of p27/ skp-2 expression more similar to MST from proposed intercalated duct origin. As a test, we allocated low/intermediate grade MEC to the group of MST of intercalated duct origin and discovered that the differences in skp-2 expression between the 2 histogenetic groups were highly significant: intercalated duct histogenesis (0%) and [27,28] while others prefer to classify them as high grade tumors [29]. In our survival study, 2 (18%) patients with MEC succumbed to their disease, and both were high grade tumors.…”

Section: Discussionmentioning

confidence: 96%

P27/SKP-2 Histochemical Profile is Relevant to Malignant Salivary Gland Tumors (MST) Histogenesis and Tumor Grade

Akrish

Ben‐Izhak

Peled

2011

Head and Neck Pathol

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Malignant salivary gland tumors (MST) represent over more than 24 distinct morphological subtypes. Most high grade tumors arise from the excretory duct portion of the salivary gland apparatus; the remainder from the intercalated duct portion. Altered p27/skp-2 expression has been associated with tumor aggressiveness and histologic differentiation. In our study, we analyzed p27/skp-2 expression proteins on series of malignant salivary gland tumors in order to assess their value as a histogenetic marker, which is relevant to tumor grade. 61 MST cases were segregated by proposed histogenesis and immunohistochemistry was performed using antibodies directed against p27 and skp-2. MST of proposed intercalated duct origin (n = 27) showed strong p27 expression (n = 25/27; 93%) in the vast majority of cases and all cases weakly expressed skp-2. MST of proposed excretory duct origin (n = 32) showed strong p27 expression (n = 18/32; 56%) and moderately strong/ strong skp-2 expression (n = 18/32; 56%), respectively, in over half the cases. MST of intercalated duct origin showed evident p27/skp-2 inverse correlation. Differences in p27/skp-2 expression among the MST subtypes correlated with histogenesis and tumor grade, which reinforces the notion that tumor behavior is relevant to the portion of the salivary gland unit from which they arise. MST of proposed intercalated duct origin strongly expressed p27, and not skp-2, unlike MST of proposed excretory duct origin. The immunohistochemical profile of high grade mucoepidermoid carcinoma was distinct from its low/intermediate grade counterparts, suggesting a separate identity. These results may influence future decision making when formulating workable MST categorization schemes. Further studies on a larger series of MST are warranted in order to support the value of our findings.

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Treatment and survival outcomes based on histologic grading in patients with head and neck mucoepidermoid carcinoma

Cited by 143 publications

References 34 publications

SALIVARY GLANDS; CLINICAL & HISTOPATHOLOGICAL SPECTRUM OF ADENOID CYSTIC CARCINOMA & MUCOEPIDERMOID CARCINOMAS REPORTED AT TERTIARY CARE HOSPITALS IN LAHORE

SALIVARY GLANDS; CLINICAL & HISTOPATHOLOGICAL SPECTRUM OF ADENOID CYSTIC CARCINOMA & MUCOEPIDERMOID CARCINOMAS REPORTED AT TERTIARY CARE HOSPITALS IN LAHORE

Genomic profiles and CRTC1–MAML2 fusion distinguish different subtypes of mucoepidermoid carcinoma

P27/SKP-2 Histochemical Profile is Relevant to Malignant Salivary Gland Tumors (MST) Histogenesis and Tumor Grade

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